Free MLLC-3-NCRA - Maine

Filing Fee $35.00 for each limited liability company listed

LIMITED LIABILITY COMPANY

STATE OF MAINE NONCOMMERCIAL REGISTERED AGENT STATEMENT OF APPOINTMENT or CHANGE
_____________________ Deputy Secretary of State

A True Copy When Attested By Signature

______________________________________
(Name of Limited Liability Company)

_____________________ Deputy Secretary of State

Pursuant to 5 MRSA §§105, 108, & 109 the undersigned limited liability company executes and delivers the following statement of appointment and/or change of address by a noncommercial Registered Agent.

FIRST:

("X" all boxes that apply)

A. B. C. D.

change of address change to/of noncommercial registered agent and address change of noncommercial registered agent change in name of current noncommercial registered agent

SECOND:

The name and address of the registered agent appearing on the record in the Secretary of State's office: _______________________________________________________________________________________________ (name of current registered agent) _______________________________________________________________________________________________ (physical street address, city, state and zip code) _______________________________________________________________________________________________ (mailing address if different from above)

THIRD:

(For foreign limited liability companies only) Jurisdiction of Organization: ________________________________________________________________ __________________________________________

Date authorized to transact business in the State of Maine:

Form No. MLLC-3-NCRA (1 of 2)

FOURTH:

Complete this Item as follows based on your selection in Item First:

A. B. C. D.

The new address of the noncommercial registered agent (provide address information only); The name and address of the new noncommercial registered agent (provide name and address information); The name of the new noncommercial registered agent (provide name only); OR The new name of the current noncommercial registered agent (provide name only).

_______________________________________________________________________________________________ (name of new noncommercial registered agent or new name of current noncommercial registered agent) _______________________________________________________________________________________________ (physical street address, not a P.O. Box ­ city, state and zip code) _______________________________________________________________________________________________ (mailing address if different from above) FIFTH: Pursuant to 5 MRSA §108.3, the registered agent as listed above has consented to serve as the registered agent for this limited liability company.

SIXTH:

The undersigned noncommercial registered agent of the following limited liability company(s) has notified each limited liability company of the change indicated in Item First A or D:
Name of Limited Liability Company Jurisdiction Date authorized or organized in Maine

_______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ Names of additional limited liability companies attached hereto as Exhibit ___, and made a part hereof. Dated _________________________ *By ____________________________________________________ (signature) ____________________________________________________ (type or print name and capacity) *This statement MUST be signed as follows: (1) if Item First, A or D was selected, then by the noncommercial registered agent; OR (2) if Item First, B or C was selected, then by: (i) at least one manager; OR (ii) at least one member if the limited liability company is managed by the members; OR (iii) any duly authorized person. 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. MLLC-3-NCRA (2 of 2) 7/1/2008

Filer Contact Cover Letter

To:

Department of the Secretary of State Division of Corporations, UCC and Commissions 101 State House Station Augusta, ME 04333-0101

Tel. (207) 624-7752

Name of Entity (s): _______________________________________________________________________ _______________________________________________________________________ List type of filing(s) enclosed (i.e. Articles of Incorporation, Articles of Merger, Articles of Amendment, Certificate
of Correction, etc.) Attach additional pages as needed.

________________________________________________________________________ ________________________________________________________________________ Special handling request(s): (check all that apply) Hold for pick up Expedited filing - 24 hour service ($50 additional filing fee per entity, per service) Expedited filing - Immediate service ($100 additional filing fee per entity, per service) Total filing fee(s) enclosed: $ ________________ Contact Information ­ questions regarding the above filing(s), please call or email: (failure to provide a contact name and telephone number or email address will result in the return of the erroneous filing (s) by the Secretary of State's office) ___________________________________
(Name of contact person)

___________________________________
(Daytime telephone number)

____________________________________________________
(Email address)

The enclosed filing(s) and fee(s) are submitted for filing. Please return the attested copy to the following address:

______________________________________________________________________________
(Name of attested recipient)

_____________________________________________________________________________________________
(Firm or Company)

_____________________________________________________________________________________________
(Mailing Address)

_____________________________________________________________________________________________
(City, State & Zip)