Filing Fee $75.00 DOMESTIC LIMITED PARTNERSHIP STATE OF MAINE STATEMENT OF TERMINATION _____________________ Deputy Secretary of State A True Copy When Attested By Signature ______________________________________ (Name of Limited Partnership) _____________________ Deputy Secretary of State Pursuant to 31 MRSA §1323, the undersigned limited partnership executes and delivers the following Statement of Termination: FIRST: SECOND: The date the original certificate of limited partnership was filed: ____________________________________________ Any other information as determined by the general partners filing this statement or by a person appointed pursuant to 31 MRSA §1393, sub-§3 or 4, if any, are set forth in Exhibit _____ attached hereto and made a part hereof. Dated __________________________ General Partner(s) ** ___________________________________________________ (signature) ___________________________________________________ (type or print name) ___________________________________________________ (signature) ___________________________________________________ (type or print name) ___________________________________________________ (signature) ___________________________________________________ (type or print name) For General Partner(s) which are Entities Name of Entity _________________________________________________________________________________________________ By ________________________________________________ (authorized signature) ___________________________________________________ (type or print name and capacity) *This statement MUST be signed by ALL general partners listed in the certificate or by the person appointed pursuant to 31 MRSA §1393, sub-§3 or 4 to wind up the dissolved limited partnership's activities. (31 MRSA §1324.1.G) The execution of this application 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 American LegalNet, Inc. www.FormsWorkFlow.com Form No. MLPA-11C (1 of 1) Rev. 7/1/2007 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