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Filing Fee $35.00 LIMITED LIABILITY COMPANY STATE OF MAINE NONCOMMERCIAL REGISTERED AGENT STATEMENT OF RESIGNATION (for a Maine or Foreign LLC) _____________________ Deputy Secretary of State A True Copy When Attested By Signature ________________________________________ (Name of Maine or Foreign Limited Liability Company) _____________________ Deputy Secretary of State Pursuant to 5 MRSA §111, the undersigned noncommercial registered agent executes and delivers the following statement of resignation from serving as agent for service of process for this limited liability company: FIRST: The name and address of the resigning noncommercial registered agent as it appears on the record in the Secretary of State's office: _______________________________________________________________________________________________ (name of current noncommercial registered agent) _______________________________________________________________________________________________ (physical street address, city, state and zip code as it appears on the record) SECOND: The name and address of the person to which the noncommercial registered agent will send the required notice: ______________________________________________________________________________________________ (insert name) at_____________________________________________________________________________________________ (mailing address including zip code) the ________________________________________________________________ of the limited liability company. (title of person notified) DATED _________________________ __________________________________________________ (signature of resigning noncommercial registered agent) __________________________________________________ (type or print name) Pursuant to 5 MRSA §111.3, the registered agent shall promptly furnish the represented entity notice in a record of the date on which a statement of resignation was filed. 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 American LegalNet, Inc. www.FormsWorkFlow.com Form No. MLLC-3A-NCRA 7/1/2011 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