Filing Fee $20.00
LIMITED LIABILITY PARTNERSHIP
STATE OF MAINE
TERMINATION OF STATEMENT OF
INTENTION TO DO BUSINESS
Deputy Secretary of State
UNDER AN ASSUMED NAME
A True Copy When Attested By Signature
______________________________________
Deputy Secretary of State
(Name of Limited Liability Partnership)
Pursuant to 31 MRSA §805.5., the undersigned, a limited liability partnership (formed under the laws of the State of Maine) (formed
under the laws of the State of _________________________, and authorized to do business in Maine), gives notice of its intention to
terminate the use of an assumed name:
FIRST:
The address of the registered office of the limited liability partnership in the State of Maine is ___________________
_________________________________________________________________________________________________
(street, city, state and zip code)
SECOND:
The limited liability partnership intends to terminate the assumed name of
_________________________________________________________________________________________________
PARTNER(S)*
DATED __________________________
___________________________________________________
____________________________________________________
(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)
*Certificate MUST be signed by at least one partner (§826.1.B. and §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-5A Rev. 4/16/2001
TEL. (207) 624-7740