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