Free MBCA-14 - Maine

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DOMESTIC BUSINESS CORPORATION STATE OF MAINE

CERTIFICATE OF EXCUSE
_____________________ Deputy Secretary of State A True Copy When Attested By Signature _____________________ Deputy Secretary of State

______________________________________
(Name of Corporation)

Pursuant to 13-C MRSA §1621.4, the undersigned corporation executes and delivers the following Certificate of Excuse: FIRST: SECOND: The corporation has ceased to transact business. The corporation is not indebted to this State for failure to file an annual report and to pay any fees or penalties accrued. If the excuse process is completed on or before June 1st, then the Annual Report covering the previous calendar year is not required. The effective date of the certificate of excuse (if other than the date of filing of the certificate of excuse): _______________________________.

THIRD:

DATED _________________________

*By __________________________________________________
(signature of any duly authorized person)

__________________________________________________
(type or print name and capacity)

*This document MUST be signed by any duly authorized officer OR the clerk. (13-C MRSA §121.5) 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-14 (1 of 1) Rev. 8/1/2004 TEL. (207) 624-7752