FIFTH:
The Registered Agent is a: (select either a Commercial or Noncommercial Registered Agent)
Commercial Registered Agent
CRA Public Number: ____________________
__________________________________________________________________________________
(Name of commercial registered agent)
Noncommercial Registered Agent
__________________________________________________________________________________
(Name of noncommercial registered agent)
__________________________________________________________________________________
(physical location, not P.O. Box – street, city, state and zip code)
__________________________________________________________________________________
(mailing address if different from above)
SIXTH:
Pursuant to
5 MRSA
§105.2, the registered agent listed above has consented to serve as the registered agent
for this limited liability company.
SEVENTH:
Other matters the members determine to include are set forth in the attached Exhibit ______, and made a part hereof.
**Authorized person(s)
Dated ________________________________
___________________________________________________
_________________________________________________
(Signature of authorized person)
(Type or print name of authorized person)
___________________________________________________
_________________________________________________
(Signature of authorized person)
(Type or print name of authorized person)
*Examples of professional service limited liability companies are accountants, attorneys, chiropractors, dentists, registered nurses and
veterinarians. (This is not an inclusive list – see
13 MRSA
§723.7)
**Pursuant to
31 MRSA
§1676.1.A, Certificate of Formation MUST be signed by at least one authorized person.
The execution of this certificate constitutes an oath or affirmation under the penalties of false swearing under
17-A MRSA
§453.
Please remit your payment made payable to the Maine Secretary of State.
Submit completed form to:
Secretary of State
Division of Corporations, UCC and Commissions
101 State House Station
Augusta, ME 04333-0101
Telephone Inquiries: (207) 624-7752
Email Inquiries:
CEC.Corporations@Maine.gov
Form No. MLLC-6 (2 of 2) Rev. 10/31/2012
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