Statement Of Merger {MLLC-10}

Filing Fee $150.00 LIMITED LIABILITY COMPANY STATE OF MAINE STATEMENT OF MERGER (Relating to a LLC) _____________________ Deputy Secretary of State A True Copy When Attested By Signature _____________________ Deputy Secretary of State Pursuant to 31 MRSA §1641, the undersigned survivor of the merger executes and delivers the following Statement of Merger: FIRST: Constituent Organizations that are Parties to the Merger: Name Form of Organization Jurisdiction Date of Organization _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ Name, form, jurisdiction and date of organization of additional limited liability companies or other constituent organizations are attached as Exhibit ____, and made a part hereof. SECOND: Surviving Organization: Name of surviving organization: ___________________________________________________________________ Form of surviving organization: _____________________________________ Jurisdiction of governing statute: _____________________ Date of its organization: _________________________ Address of its principal office: ______________________________________________________________________ THIRD: (Check only one box) The surviving organization is created by this merger. The organizational document that creates this surviving organization is attached; or The surviving organization existed before the merger. (Check only one box below) Amendments provided for in the plan of merger for the organizational document that created the surviving organization that are in the public record are attached; or The organizational documents remain unchanged. American LegalNet, Inc. www.FormsWorkFlow.com Form No. MLLC-10 (1 of 3) FOURTH: Date the merger is effective under the governing statute of the surviving organization: ________________________ FIFTH: The merger was approved as required by each constituent organization's governing statute and as required by the organizational documents of each constituent organization that is party to this merger. (Foreign Surviving Organization Only) The surviving foreign organization acknowledges it may be served with process in this State by certified mail and the address of its principal office for the purpose of §1644.2 is: ____________________________________________________________________ ____________________________________________________________________ SIXTH: SEVENTH: Additional information required by the governing statute of any constituent organization is set forth in the attached Exhibit _____, and made a part hereof. Must Be Completed By the First Constituent Organization to the Merger ____________________________________________________________________________ (Name and form of participating constituent organization) ___________________________________________________ (*Authorized signature) ___________________________________________________ (*Authorized signature) _____________________________ (Date) ___________________________________________ (Type or print name and capacity) ___________________________________________ (Type or print name and capacity) Must Be Completed By the Second Constituent Organization to the Merger ____________________________________________________________________________ (Name and form of participating constituent organization) ___________________________________________________ (*Authorized signature) ___________________________________________________ (*Authorized signature) _____________________________ (Date) ___________________________________________ (Type or print name and capacity) ___________________________________________ (Type or print name and capacity) Must Be Completed By the Third Constituent Organization to the Merger ____________________________________________________________________________ (Name and form of participating constituent organization) ___________________________________________________ (*Authorized signature) ___________________________________________________ (*Authorized signature) Form No. MLLC-10 (2 of 3) _____________________________ (Date) ___________________________________________ (Type or print name and capacity) ___________________________________________ (Type or print name and capacity) American LegalNet, Inc. www.FormsWorkFlow.com Must Be Completed By the Fourth Constituent Organization to the Merger ____________________________________________________________________________ (Name and form of participating constituent organization) ___________________________________________________ (*Authorized signature) ___________________________________________________ (*Authorized signature) _____________________________ (Date) ___________________________________________ (Type or print name and capacity) ___________________________________________ (Type or print name and capacity) (Copy this page, and modify participant number, if more signature spaces are needed.) *Pursuant to 31 MRSA §§1643.1 and 1676.1, this statement of merger must be signed by a person authorized by each constituent organization that is party to this merger. The execution of this certificate constitutes an oath or affirmation, under the penalties of false swearing under17-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 Form No. MLLC-10 (3 of 3) 7/1/2011 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. ________________________________________________________________________ ______________________