Free MPA-1 - Maine

Filing Fee $20.00

PARTNERSHIP

STATE OF MAINE

STATEMENT OF DISSOCIATION
_____________________ Deputy Secretary of State

______________________________________
(Name of Partnership)

A True Copy When Attested By Signature

_____________________ Deputy Secretary of State

Pursuant to 31 MRSA §1074, the undersigned partner or partnership executes and delivers the following Statement of Dissociation: FIRST: The partner named herein is dissociated from the above named partnership. ___________________________________________________________ (Name of Partner) SECOND: The undersigned declares under penalty of perjury that the contents of this statement are accurate.

Dated __________________________

Partner(s)* ___________________________________________________
(signature)

___________________________________________________
(type or print name)

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

__________________________________________________
(type or print name and capacity)

*Statement MUST be signed by a partner (31 MRSA §1005.3) 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. MPA-1 (1 of 1) 7/1/2007