Form Mllc-12 - Foreign Limited Liability Company Application For Authority To Do Business - 2005 Page 2
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3SIXTH:
The name of its Registered Agent, an individual Maine resident or a corporation, foreign or domestic, authorized to do
business or carry on activities in Maine, and the address of the registered office shall be:
_______________________________________________________________________________________________
(name)
_______________________________________________________________________________________________
(physical location - street (not P.O. Box), city, state and zip code)
_______________________________________________________________________________________________
(mailing address if different from above)
The Secretary of State of Maine is an agent upon whom service of process may be served pursuant to §722.3.
SEVENTH:
The name and business, residence or mailing address of each manager, if any, is
NAME
ADDRESS
____________________________________
___________________________________________________
____________________________________
___________________________________________________
____________________________________
___________________________________________________
Names and addresses of additional managers are attached hereto as Exhibit ____, and made a part hereof.
EIGHTH:
The date on which the foreign limited liability company first did, or intends to do, business in the State of Maine is
_______________________________.
NINTH:
This application is accompanied by a certificate of existence or a document of similar import duly authenticated by the
Secretary of State or other official having custody of limited liability company records in the state or country under
whose law the foreign limited liability company is organized. The certificate of existence must have been made not
more than 90 days prior to the delivery of this application for filing.
DATED _____________________________
___________________________________________________
(AUTHORIZED SIGNATURE***)
___________________________________________________
(Type or print name and capacity)
For Authorized Signature(s) on behalf of Entities
Name of Entity _________________________________________________________________________________________________
By ________________________________________________
___________________________________________________
(Authorized signature)
(Type or print name and capacity)
FORM NO. MLLC-12 (2 of 3)
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