Filing Fee $20.00 LIMITED LIABILITY PARTNERSHIP STATE OF MAINE TERMINATION OF STATEMENT OF INTENTION TO DO BUSINESS UNDER AN ASSUMED OR FICTITIOUS NAME _____________________ Deputy Secretary of State A True Copy When Attested By Signature ______________________________________ (Real Name of Limited Liability Partnership) _____________________ Deputy Secretary of State Pursuant to 31 MRSA �805-A.8, the undersigned limited liability partnership executes and delivers the following Termination of Statement of Intention to do Business Under an Assumed or Fictitious Name: FIRST: SECOND: The limited liability partnership no longer intends to transact business under an assumed or fictitious name. The limited liability partnership intends to terminate the assumed or fictitious name of ______________________________________________________________________________________________. PARTNER(S)* ___________________________________________________ (signature) DATED __________________________ ___________________________________________________ (type or print name and capacity) For Partner(s) which are Entities Name of Entity ________________________________________________________________________________________________ By _______________________________________________ (authorized signature) ___________________________________________________ (type or print name and capacity) *Certificate MUST be signed by at least one partner (�826.1.B and �860.1). The execution of this certificate constitutes an oath or affirmation under the penalties of false swearing under Title 17-A, section 453. 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. MLLP-5A Rev. 7/1/2003 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