Filing Fee $145.00 DOMESTIC OR FOREIGN UNINCORPORATED ENTITY STATE OF MAINE ARTICLES OF ENTITY CONVERSION _____________________ Deputy Secretary of State A True Copy When Attested By Signature ______________________________________ (Name of Unincorporated Entity Prior to Conversion) _____________________ Deputy Secretary of State Pursuant to 13-C MRSA §955.2 or §955.3, the undersigned unincorporated entity executes and delivers the following Articles of Entity Conversion: FIRST: The name of the unincorporated entity is changed as follows (the name must satisfy the requirements of 13-C MRSA §401): _______________________________________________________________________________________________ SECOND: (Foreign Unincorporated Entity Only) The unincorporated entity was organized in (state or country) ________________________________ and the date of organization was ___________________. THIRD: ("X" one box only.) (Domestic Unincorporated Entity) The plan of entity conversion was duly approved in accordance with the organic law of the unincorporated entity. (Foreign Unincorporated Entity) The conversion of the unincorporated entity was duly approved in the manner required by its organic law. FOURTH: All the statements required to be set forth in Articles of Incorporation (Form MBCA-6-1) are attached as Exhibit ________. FIFTH: The effective date of the articles of entity conversion (if other than the date of filing of the articles of entity conversion) is _______________________________. 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. (13-C MRSA §955.2 or §955.3) 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-21A (1 of 1) Rev. 8/1/2004 TEL. (207) 624-7752 American LegalNet, Inc. www.FormsWorkFlow.com 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) American LegalNet, Inc. www.FormsWorkFlow.com