Form Mlpa-12a - Amended Application For Authority To Do Business - Maine Secretary Of State Page 2
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1
2FIFTH:
The name of each withdrawing general partner is (If no change, so indicate.)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Names of additional withdrawing general partners are attached hereto as Exhibit ___, and made a part hereof.
SIXTH:
The new address of the registered or principal office, wherever located, is (If no change, so indicate.)
_______________________________________________________________________________________________
(physical location - street (not P.O. Box), city, state and zip code)
_______________________________________________________________________________________________
(mailing address if different from above)
AND/OR
If the business, residence or mailing address of any general partner has changed, the new address is (If no change, so
indicate.)
NAME
NEW ADDRESS
____________________________________
___________________________________________________
____________________________________
___________________________________________________
____________________________________
___________________________________________________
Names and new addresses of general partners are attached hereto as Exhibit ____, and made a part hereof.
SEVENTH:
Other amendments to the application, if any, are set forth in Exhibit ___ attached hereto and made a part hereof.
DATED __________________________
GENERAL PARTNER(S)*
___________________________________________________
___________________________________________________
(signature)
(type or print name)
For General Partner(s) which are Entities
Name of Entity ________________________________________________________________________________________________
By _______________________________________________
___________________________________________________
(authorized signature)
(type or print name and capacity)
The limited partnership name as used in the State of Maine must contain one of the following: "Limited Partnership", "L.P." or "LP"
(§403-A). If the addition of these words is the only difference from the limited partnership's real name in its jurisdiction of organization,
n
o further action is required.
*Certificate MUST be signed by
(1) at least one general partner OR
(2) any duly authorized person.
The execution of this certificate constitutes an oath or affirmation under the penalties of false swearing under
Title 17-A, section
453.
Please remit your payment made payable to the Maine Secretary of State.
SUBMIT COMPLETED FORMS TO: CORPORATE EXAMINING SECTION, SECRETARY OF STATE,
101 STATE HOUSE STATION, AUGUSTA, ME 04333-0101
FORM NO. MLPA-12A (2 of 2) Rev. 7-1-2003
TEL. (207) 624-7740
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