Deputy Secretary of State A True Copy When Attested By Signature Deputy Secretary of State Filing Fee $10.00 Pursuant to 13-B MRSA 2471101, the undersigned corporation executes and delivers for filing the following Statement of Intent to Dissolve the corporation. FIRST: The names and respective addresses of its officers and directors are: Title Name Address President Treasurer Secretary Clerk Directors: (List additional directors on reverse side) SECOND: ("X" one box only) Exhibit A attached hereto is a copy of the written consent signed by: All members of the corporation entitled to vote. All directors of the corporation, there being no members or no members entitled to vote. THIRD: The undersigned corporation understands that the filing of this document does not complete the dissolution process. You must also file Articles of Dissolution, form MNPCA-11D or 11E. FOURTH: The address of the registered office of the corporation in the State of Maine is (street, city, state and zip code) FORM NO. MNPCA-11 (1 of 2) DOMESTIC NONPROFIT CORPORATION STATE OF MAINE STATEMENT OF INTENT TO DISSOLVE (Written Consent of Members or Directors) (Name of Corporation) American LegalNet, Inc. www.FormsWorkFlow.com DATED *By (signature) (type or print name and capacity) *By (signature) (type or print name and capacity) Notice of the filing of this statement shall be mailed to each known creditor of the corporation pursuant to 13-B MRSA 2471101.2. *This document MUST be signed by any authorized officer. (13-B MRSA 247104.1.B) 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. MNPCA-11 (2 of 2) Rev. 1/23/2018 MUST BE COMPLETED FOR VOTE OF MEMBERS I certify that I have custody of the minutes showing the above action by the members. (signature of clerk, secretary or asst. secretary) American LegalNet, Inc. www.FormsWorkFlow.com Filer Contact Cover Letter To: Department of the Secretary of State Tel. (207) 624-7752 Division of Corporations, UCC and Commissions 101 State House Station Augusta, ME 04333-0101 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 226 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 State222s 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