Filing Fee $35.00 DOMESTIC BUSINESS CORPORATION STATE OF MAINE COMMERCIAL CLERK _____________________ Deputy Secretary of State STATEMENT OF APPOINTMENT or CHANGE A True Copy When Attested By Signature ______________________________________ _____________________ Deputy Secretary of State (Name of Corporation as it appears on the records of the Secretary of State) Pursuant to 5 MRSA §§105 & 108 the undersigned corporation executes and delivers the following statement of appointment or change of a commercial clerk. FIRST: The name and address of the current clerk appearing on the record in the Secretary of State's office: _______________________________________________________________________________ (name of current clerk) _______________________________________________________________________________ (physical street address, city, state and zip code) SECOND: The new CRA Public number is: __________________________ The name of the new CRA is: _______________________________________________________ THIRD: Pursuant to 5 MRSA §108.3, the clerk as listed above has consented to serve as the clerk for this corporation. FOURTH: Upon a change in commercial clerk, one of the following must be completed: ("X" one box only.) The change of commercial clerk was duly authorized by the board of directors of the corporation and that the power to appoint the commercial clerk is not reserved to the shareholders by the articles or the bylaws. The change of commercial clerk was duly authorized by the shareholders of the corporation. DATED _________________________ *By ______________________________________________ (signature) _______________________________________________ (type or print name and capacity) *This statement MUST be signed by any duly authorized officer. 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: CEC.Corporations@Maine.gov Form No. MBCA-3-CRA 7/1/2008 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