Filing Fee $35.00
LIMITED PARTNERSHIP
STATE OF MAINE
STATEMENT OF DISSOCIATION
_____________________ Deputy Secretary of State
A True Copy When Attested By Signature
______________________________________
(Name of Limited Partnership)
_____________________ Deputy Secretary of State
Pursuant to 31 MRSA §1375.1.D, the undersigned general partner executes and delivers the following Statement of Dissociation:
FIRST:
The general partner named herein is dissociated from the above named limited partnership. _______________________________________________________________________ (Name of General Partner)
Dated __________________________
General Partner(s) *
___________________________________________________
(signature)
___________________________________________________
(type or print name)
For General Partner(s) which are Entities Name of Entity _________________________________________________________________________________________________ By ________________________________________________
(authorized signature)
___________________________________________________
(type or print name and capacity)
*Certificate MUST be signed by the person dissociated as a general partner. (31 MRSA §1324.1.G) The execution of this application 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: [email protected]
Form No. MLPA-9B (1 of 1) Rev. 7/1/2007