Free MBCA-19B - Maine

Filing Fee $35.00

BUSINESS CORPORATION STATE OF MAINE

STATEMENT OF ABANDONMENT OF DOMESTICATION BY A DOMESTIC OR FOREIGN BUSINESS CORPORATION

_____________________ Deputy Secretary of State

A True Copy When Attested By Signature

______________________________________
(Name of Corporation)

_____________________ Deputy Secretary of State

Pursuant to 13-C MRSA §926, the undersigned corporation executes and delivers the following Statement of Abandonment of Domestication by a Domestic or Foreign Business Corporation: ("X" one box only.) (Domestic Business) The domestication is abandoned after articles of charter surrender have been filed with the Secretary of State but before the domestication has become effective on __________________________. (Foreign Business) The domestication of this foreign business corporation in this State is abandoned in accordance with the laws of the foreign jurisdiction after articles of domestication have been filed with the Secretary of State. This statement takes effect upon filing, and the domestication is considered abandoned and does not become effective.

FIRST:

SECOND:

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. (§926) 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-19B 7-1-2003 TEL. (207) 624-7752