Form Mnpca-5 - Statement Of Intention To Carry On Activities Under An Assumed Name - Maine Secretary Of State Page 2
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1
2DATED
*By
(signature)
(type or print name and capacity)
*By
(signature)
(type or print name aIxi capacity)
*If this is a domestic corporation, this document ~
be signed by
(I) the ~
or Secretary OR
(2) the President or a vice-pres. together with the Secreta" or an ass't. sec., or a 2nd certifying officer OR
(3) if no such officers, then a majority of the Directors OR
(4) if no such directors, then the Members.
*If this is a foreign corporation, this document MUST be signed by any duly authorized individual.
SUBMIT COMPLETED FORMS TO: CORPORATE EXAMINING SECTION, SECRETARY OF STATE,
101 STATE HOUSE STATION, AUGUSTA, ME 04333-0101
FORM NO. MNPCA-5 Rev.8/2000
TEL. (201) 287-4195
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