Filing Fee $70.00
DOMESTIC
BUSINESS CORPORATION
STATE OF MAINE
ARTICLES OF CHARTER SURRENDER
_____________________
(Upon Entity Conversion)
Deputy Secretary of State
A True Copy When Attested By Signature
______________________________________
(Name of Corporation Prior to Conversion)
_____________________
Deputy Secretary of State
Pursuant to
13-C MRSA §§956
and 957, the undersigned corporation executes and delivers the following Articles of Charter Surrender:
FIRST:
The articles of charter surrender are being filed in connection with the conversion of the corporation to a foreign
unincorporated entity and the effective date of the conversion is (date) ______________________________________.
SECOND:
The conversion was duly approved by the shareholders in the manner required by this Act and the corporation’s articles
of incorporation.
THIRD:
The jurisdiction under the laws of which the surviving entity is organized is __________________________________.
FOURTH:
If the surviving entity is a nonfiling entity, the address of its executive office immediately after the conversion.
_______________________________________________________________________________________________
FIFTH:
The surviving entity shall appoint the Secretary of State as its agent for service of process in a proceeding to enforce the
rights of shareholders who exercise appraisal rights in connection with the conversion and shall provide a mailing
address to which the Secretary of State may mail a copy of any process served on the Secretary of State.
_______________________________________________________________________________________________
(mailing address)
SIXTH:
The corporation agrees that it will promptly pay the amount, if any, to which the shareholders are entitled under
chapter
13.
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. (§956.1)
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-21B 7-1-2003
TEL. (207) 624-7740
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