Filing Fee $145.00 DOMESTIC BUSINESS CORPORATION STATE OF MAINE ARTICLES OF ENTITY CONVERSION _____________________ Deputy Secretary of State A True Copy When Attested By Signature ______________________________________ (Name of Corporation Prior to Conversion) _____________________ Deputy Secretary of State Pursuant to 13-C MRSA §955.1, the undersigned corporation executes and delivers the following Articles of Entity Conversion: FIRST: The name of the corporation is changed as follows (the name must satisfy the organic law of the surviving entity): _______________________________________________________________________________________________ SECOND: THIRD: The type of unincorporated entity that the surviving entity will be: _________________________________________. The plan of entity conversion was duly approved by the shareholders in the manner required by this Act and the corporation's articles of incorporation. If the surviving entity is a filing entity, attached is Exhibit ________ which contains all the provisions required to be set forth in its public organic document with any other desired provisions that are permitted. For a Domestic Limited Liability Company, attach form MLLC-6. For a Domestic Limited Partnership, attach form MLPA-6-1. FIFTH: The effective date of the articles of entity conversion (if other than the date of filing of the articles of entity conversion) is _______________________________. FOURTH: 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 §955.1) 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-21 (1 of 1) Rev. 12/13/2013 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