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FOREIGN BUSINESS CORPORATION

STATE OF MAINE
_____________________ Deputy Secretary of State

CONSENT TERMINATING NAME REGISTRATION

A True Copy When Attested By Signature

______________________________________
(Foreign Registered Name)

_____________________ Deputy Secretary of State

Pursuant to 13-C MRSA §403.5, the undersigned foreign corporation executes and delivers the following statement terminating the name registration in order for another corporation to use the name. FIRST: The state or country under the laws of which it is incorporated is____________________________________________ and the address of its principal office is located at: ______________________________________________________________________________________________

______________________________________________________________________________________________
(street, city, state and zip code)

SECOND:

The date of its incorporation is ______________________________________________________________________

THIRD:

That the above foreign corporation terminates the name registration in order for another corporation to use the name.

DATED _________________________

*By ____________________________________________________
(signature of any duly authorized officer)

____________________________________________________
(type or print name and capacity)

This document MUST be signed by any duly authorized officer. (§121.5) 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: [email protected]

Form No. MBCA-2A 3/24/2008