Filing Fee $35.00 STATE OF MAINE STATEMENT OF ABANDONMENT OF MERGER OR SHARE EXCHANGE _____________________ Deputy Secretary of State A True Copy When Attested By Signature _______________________________________________________ (Name of party to the merger or share exchange filing this document) _____________________ Deputy Secretary of State Pursuant to 13-C MRSA §1108.2, the undersigned party to the merger or share exchange executes and delivers the following Statement of Abandonment of Merger or Share Exchange: The merger or share exchange has been abandoned in accordance with this section after articles of merger or share exchange have been filed with the Secretary of State but before the merger or share exchange has become effective. The names, type of entity and jurisdiction of the parties involved in the merger or share exchange are: Name Type of Entity Jurisdiction FIRST: SECOND: _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ THIRD: This statement takes effect upon filing, and the merger or share exchange is considered abandoned and does not become effective. *By __________________________________________________ (signature of an officer or other duly authorized representative) DATED _________________________ __________________________________________________ (type or print name and capacity) *This document MUST be signed by an officer or other duly authorized representative who is a party to the merger or share exchange. (§1108.2) 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-10A 7-1-2003 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