Form Mllp-12c - Change Of Registered Agent Only Or Change Of Registered Agent And Registered Office - Maine Secretary Of State Page 2

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DATED __________________________
PARTNER(S)*
___________________________________________________
____________________________________________________
)
(signature)
(type or print name and capacity
For Partner(s) which are Entities
Name of Entity __________________________________________________________________________________________________
By ________________________________________________
____________________________________________________
(authorized signature)
(type or print name and capacity)
THE FOLLOWING SHALL BE COMPLETED BY THE REGISTERED AGENT UNLESS THIS DOCUMENT IS
ACCOMPANIED BY FORM MLLP-18 (§854.2-A.).
The undersigned hereby accepts the appointment as registered agent for the above-named limited liability partnership.
REGISTERED AGENT
DATED __________________________
___________________________________________________
____________________________________________________
)
(signature)
(type or print name
For Registered Agent which is a Corporation
Name of Corporation ______________________________________________________________________________________________
By ________________________________________________
____________________________________________________
(authorized signature)
(type or print name and capacity)
*Certificate MUST be signed by at least one partner (§860.1.).
The execution of this certificate constitutes an oath or affirmation under the penalties of false swearing under Title 17-A, section 453.
SUBMIT COMPLETED FORMS TO: CORPORATE EXAMINING SECTION, SECRETARY OF STATE,
101 STATE HOUSE STATION, AUGUSTA, ME 04333-0101
FORM NO. MLLP-12C
Rev. 4/16/2001
TEL. (207) 624-7740

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