Form Mnpca-19a - Statement Of Abandonment Of Domestication And Conversion
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1Filing Fee $35.00
FOREIGN
NONPROFIT CORPORATION
STATE OF MAINE
STATEMENT OF ABANDONMENT OF
_____________________
DOMESTICATION AND CONVERSION
Deputy Secretary of State
A True Copy When Attested By Signature
______________________________________
_____________________
(Name of Corporation)
Deputy Secretary of State
Pursuant to
13-C MRSA
§944, the undersigned corporation executes and delivers the following Statement of Abandonment of
Domestication and Conversion:
FIRST:
The domestication and conversion of this foreign nonprofit corporation in this State is abandoned in accordance with
the laws of the foreign jurisdiction after articles of domestication and conversion have been filed with the Secretary of
State.
SECOND:
This statement takes effect upon filing, and the domestication and conversion is considered abandoned and does not
become effective.
DATED _________________________
*By ___________________________________________________
(signature of an officer or other duly authorized representative)
__________________________________________________
(type or print name and capacity)
*This document MUST be signed by an officer or other duly authorized representative. (§944)
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. MNPCA-19A 7-1-2003
TEL. (207) 624-7752
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