Application For Certificate Of Revival - Maine Secretary Of State Page 2
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2
3SIXTH:
Time period needed to complete the purpose(s) specified in item fifth: ___________________________________________
SEVENTH:
The name(s) and address of party or parties requesting revival:
_________________________________________________
______________________________________________
(type or print name)
(street address)
______________________________________________
(city, state and zip code)
_________________________________________________
______________________________________________
(type or print name)
(street address)
______________________________________________
(city, state and zip code)
_________________________________________________
______________________________________________
(type or print name)
(street address)
______________________________________________
(city, state and zip code)
DATED ________________________________
________________________________________________
(signature of any duly authorized person)
________________________________________________
(type or print name)
lease remit your payment made payable to the Maine Secretary of State
P
Submit Completed Forms To:
Secretary of State
Division of Corporations, UCC and Commissions
101 State House Station
Augusta, ME 04333-0101
Telephone: (207) 624-7752
FORM NO. Revive (2 of 2)
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