Filing Fee $35.00 for each limited liability company listed FOREIGN LIMITED LIABILITY COMPANY STATE OF MAINE CHANGE OF REGISTERED AGENT and/or REGISTERED OFFICE _____________________ Deputy Secretary of State A True Copy When Attested By Signature ______________________________________ (Name of Limited Liability Company) _____________________ Deputy Secretary of State Pursuant to 31 MRSA §714, the undersigned Limited Liability Company executes and delivers the following Change of Registered Agent and/or Registered Office: FIRST: ("X" one box only.) A. change of registered office only B. change of registered agent and registered office C. change of registered agent only D. change in name of current registered agent SECOND: Complete the following if you checked box B or C: The jurisdiction of organization is _____________________________ and the date on which the limited liability company was authorized to transact business in the State of Maine is ____________________________. THIRD: The name and registered office of the registered agent appearing on the record in the Secretary of State's office: ________________________________________________________________________________________________ (name of current registered agent) ________________________________________________________________________________________________ (street, city, state and zip code) FOURTH: Complete this Item as follows based on your selection in Item First: A. B. C. D. The address of the new registered office (provide address information only); The name and registered office of the new registered agent, who must be a Maine resident or a domestic business or nonprofit corporation, a foreign business or nonprofit corporation authorized to do business or carry on activities in Maine (provide name and address information); The name of the new registered agent, who must be a Maine resident or a domestic business or nonprofit corporation, a foreign business or nonprofit corporation authorized to do business or carry on activities in Maine (provide name only); OR The new name of the current registered agent (provide name only). ________________________________________________________________________________________________ (name of new registered agent or new name of current registered agent) ________________________________________________________________________________________________ (physical location, not P.O. Box – street, city, state and zip code) ________________________________________________________________________________________________ (mailing address if different from above) FORM NO. MLLC-12C (1 of 2) American LegalNet, Inc. www.USCourtForms.com FIFTH: The undersigned registered agent of the following limited liability company(ies), who has changed the address of the registered office OR who has changed his or her name, has notified each limited liability company of the change indicated in Item Third A or D: Name of limited liability company Jurisdiction Date authorized to transact business in Maine ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Names of additional limited liability companies attached hereto as Exhibit ___, and made a part hereof. Note: The following must be signed by the proper person as designed below.* DATED _________________________ *By ____________________________________________________ (signature) ____________________________________________________ (type or print name and capacity) Acceptance of Appointment of New Registered Agent The undersigned hereby accepts the appointment as registered agent for the above-named foreign limited liability company. DATED __________________________ _________________________________________________ ___________________________________________________ (signature of registered agent) (type or print name) For Registered Agent which is a Corporation Name of Corporation _____________________________________________________________________________________________ By ________________________________________________ _______________________________________________________ (authorized signature) Note: (type or print name and capacity) If this document changes the registered agent and the new registered agent does not sign, Form MLLC-18 (31 MRSA §714.2A) must accompany this document. *This certificate MUST be signed as follows: (1) if Item First, A. was selected, then by the Registered Agent OR (2) if Item First, B. or C. was selected, at least one manager OR at least one member if the limited liability company is managed by the members OR any duly authorized person OR (3) if Item First, D. was selected, then by the Registered Agent. 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. MLLC-12C (2 of 2) Rev. 8/1/2004 TEL. (207) 624-7740 American LegalNet, Inc. www.USCourtForms.com