FOREIGN LIMITED LIABILITY COMPANY Filing Fee $250.00 STATE OF MAINE APPLICATION FOR AUTHORITY TO DO BUSINESS _____________________ Deputy Secretary of State A True Copy When Attested By Signature ______________________________________ _____________________ Deputy Secretary of State (Name of Limited Liability Company in Jurisdiction of Organization) Pursuant to 31 MRSA §712.3, the undersigned limited liability company executes and delivers the following Application for Authority to do Business: FIRST: The proposed limited liability company name* to be used in this State: _______________________________________________________________________________________________ (The name must contain one of the following: “Limited Liability Company”, “LLC” or “L.L.C.”, see 31 MRSA §603.A.1) SECOND: If the real limited liability company name is not available, the fictitious name under which it proposes to apply for authority to do business in the State of Maine is: (If not applicable, so indicate.) ______________________________________________________________________________________________ Form MLLC-5 accompanies this application. A fictitious name is a name adopted by a foreign limited liability company authorized to transact business in this State because its real name is unavailable pursuant to 31 MRSA §603-A. THIRD: Date of organization ________________________ Jurisdiction of organization _______________________________ Address of the registered or principal office, wherever located: _________________________________________________________________________________________ (physical location - street (not P.O. Box), city, state and zip code) _________________________________________________________________________________________ (mailing address if different from above) FOURTH: The foreign limited liability company validly exists as a limited liability company under the laws of the jurisdiction of its organization. The nature of the business or purposes to be conducted or promoted in the State of Maine is ______________________________________________________________________________________________. Form No. MLLC-12 (1 of 3) American LegalNet, Inc. www.FormsWorkFlow.com FIFTH: The Registered Agent is a: (select either a Commercial or Noncommercial Registered Agent) Commercial Registered Agent CRA Public Number: ____________________ __________________________________________________________________________________ (name of commercial registered agent) Noncommercial Registered Agent __________________________________________________________________________________ (name of noncommercial registered agent) __________________________________________________________________________________ (physical location, not P.O. Box – street, city, state and zip code) __________________________________________________________________________________ (mailing address if different from above) SIXTH: Pursuant to 5 MRSA §108.3, the registered agent as listed above has consented to serve as the registered agent for this limited liability company. SEVENTH: The name and business, residence or mailing address of each manager, if any, is NAME ADDRESS ____________________________________ ___________________________________________________ ____________________________________ ___________________________________________________ ____________________________________ ___________________________________________________ Names and addresses of additional managers are attached hereto as Exhibit ____, and made a part hereof. EIGHTH: The date on which the foreign limited liability company first did, or intends to do, business in the State of Maine is _______________________________________. NINTH: Check only if applicable This is a professional limited liability company qualified pursuant to 13 MRSA Chapter 22-A to provide the following professional services: (see 13 MRSA, chapter 22-A for information on what constitutes professional services) ____________________________________________________________________________________________ ____________________________________________________________________________________________ (type of professional services) Form No. MLLC-12 (2 of 3) American LegalNet, Inc. www.FormsWorkFlow.com TENTH: (For professional limited liability companies only) All of the professional limited liability companies’ members and managers, if any, are licensed in one or more states to render a professional service disclosed in its application. ELEVENTH: This application is accompanied by a certificate of existence or a document of similar import duly authenticated by the Secretary of State or other official having custody of limited liability company records in the state or country under whose law the foreign limited liability company is organized. The certificate of existence must have been made not more than 90 days prior to the delivery of this application for filing. Dated ______________________________ ___________________________________________________ (Authorized Signature**) ___________________________________________________ (Type or print name and capacity) For Authorized Signature(s)** on behalf of Entities Name of Entity _________________________________________________________________________________________________ By ________________________________________________ (Authorized signature) ___________________________________________________ (Type or print name and capacity) *The limited liability company name as used in the State of Maine must contain one of the following: "Limited Liability Company", "L.L.C." or "LLC" (31 MRSA §603-A). If the addition of these words is the only difference from the limited liability company's real name in its jurisdiction of organization, no further action is required. **Application MUST be signed by at least one authorized person (31 MRSA §712.2). The execution of this certificate constitutes an oath or affirmation under the penalties of false swearing under 17-A MRSA §453. 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. MLLC-12 (3 of 3) Rev. 10/1/2008 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