Free MLLP-5 - Maine

Filing Fee for an Assumed Name $125.00 Filing Fee for a Fictitious Name $40.00

LIMITED LIABILITY PARTNERSHIP STATE OF MAINE

STATEMENT OF INTENTION TO DO BUSINESS UNDER AN ASSUMED OR FICTITIOUS NAME

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

______________________________________
(Real Name of Limited Liability Partnership)

Pursuant to 31 MRSA §805-A, the undersigned limited liability partnership executes and delivers the following Statement of Intention to do Business Under an Assumed or Fictitious Name: FIRST: ("X" one box only.) assumed name (31 MRSA §805-A.1) fictitious name (31 MRSA §805-A.2)

The limited liability partnership intends to transact business under the assumed or fictitious name of _____________________________________________________________________________________________. Please note: A fictitious name is a name adopted by a foreign limited liability partnership authorized to transact business in this State because its real name is unavailable pursuant to 31 MRSA §803-A. Complete the following if applicable: SECOND: If such assumed name is to be used at fewer than all of the limited liability partnership's places of business in this State, the location(s) where it will be used is (are): ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ Additional locations are attached hereto as Exhibit ___, and made a part hereof. THIRD: (Foreign Limited Liability Partnership Only) Jurisdiction of organization ______________________________________________________ and the date on which the limited liability partnership was authorized to transact business in Maine _________________________________ FORM NO. MLLP-5 (1 of 2)

DATED __________________________

Partner(s)* ___________________________________________________
(signature)

__________________________________________________
(type or print name and capacity)

For Partner(s) which are Entities Name of Entity _________________________________________________________________________________________________ By _______________________________________________
(authorized signature)

___________________________________________________
(type or print name and capacity)

*Certificate MUST be signed by (1) at least one partner OR (2) any duly authorized person. The execution of this certificate 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 FORMS TO: CORPORATE EXAMINING SECTION, SECRETARY OF STATE, 101 STATE HOUSE STATION, AUGUSTA, ME 04333-0101 FORM NO. MLLP-5 (2 of 2) Rev. 8/1/2004 TEL. (207) 624-7752