Form Mbca-12 - Application For Authority To Do Business Page 3
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3Acceptance of Appointment of Registered Agent
The undersigned hereby accepts the appointment as registered agent for the above-named foreign business corporation.
DATED __________________________
REGISTERED AGENT
___________________________________________________
___________________________________________________
(signature)
(type or print name)
For Registered Agent which is a Corporation
Name of Corporation ____________________________________________________________________________________________
By _______________________________________________
__________________________________________________
(authorized signature)
(type or print name and capacity)
Note: If the registered agent does not sign, Form MBCA-18. (§1503.3) must accompany this document.
**The professional corporation name as used in the State of Maine must contain one of the following: “chartered,” “professional
corporation,” “professional association” or “service corporation” or the abbreviation “P.C.,” “P.A.” or “S.C.”.
*This document MUST be signed by any duly authorized officer. (§121.5)
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. MBCA-12 (3 of 3) 7/1/2003
TEL. (207) 624-7740
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Parent category: Legal