Filing Fee $5.00 per month. Renewal Fee $50.00. FOREIGN NONPROFIT CORPORATION STATE OF MAINE APPLICATION FOR REGISTRATION OF NAME _____________________ Deputy Secretary of State A True Copy When Attested By Signature ______________________________________ (Name of foreign corporation) _____________________ Deputy Secretary of State Pursuant to 13-B MRSA §303-A, the undersigned foreign corporation executes and delivers the following Application for Registration of Name: FIRST: new OR renewal of a registration of corporate name. A new ("X" one box only.) This application is for a application expires at the end of the calendar year in which the application is filed. A renewal application can be filed between October 1st and December 31st. The renewal application, when filed, renews the registration of corporate name for the following calendar year. The state or country under the laws of which it is incorporated is __________________________________________ and the address of its principal office is located at: _______________________________________________________________________________________________ ______________________________________________________________________________________________. (street, city, state and zip code) SECOND: THIRD: FOURTH: The date of its incorporation is _____________________________________________________________________. A brief statement of the nature of the corporation's activities: ______________________________________________________________________________________________. FIFTH: This application is accompanied by a certificate of existence or a document of similar import duly authenticated by the Secretary of State or other official having custody of corporate records in the state or country under whose law the foreign corporation is incorporated. The certificate of existence must have been made not more than 90 days prior to the delivery of this application for filing. *By ___________________________________________________ (signature of any duly authorized individual) DATED _________________________ ___________________________________________________ (type or print name and capacity) The filing of this application does not authorize a corporation to carry on activities in Maine. *This document MUST be signed by any duly authorized individual. 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. MNPCA-2 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