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Statement Of Foreign Qualification To Conduct Activities MLLC-12 - Maine
| Statement Of Foreign Qualification To Conduct Activities Form. This is a Maine form and can be used in Foreign Limited Liability Company Secretary Of State . |
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FOREIGN LIMITED LIABILITY COMPANY STATE OF MAINE Filing Fee $250.00 STATEMENT OF FOREIGN QUALIFICATION TO CONDUCT ACTIVITIES _____________________ Deputy Secretary of State A True Copy When Attested By Signature ______________________________________ (Name of Limited Liability Company in Jurisdiction of Organization) _____________________ Deputy Secretary of State Pursuant to 31 MRSA §1622, the undersigned limited liability company executes and delivers the following Statement of Foreign Qualification: FIRST: If the name of the limited liability company in the jurisdiction of organization does not contain one of the words or abbreviations required by 31 MRSA § 1508.1 ("limited liability company" or "limited company" or the abbreviation "L.L.C.," "LLC," "L.C." or "LC" or, in the case of a low-profit limited liability company, "L3C" or "l3c"), the proposed name to be used in this State in compliance with this requirement is: * (If not applicable, so indicate.) _______________________________________________________________________________________________ SECOND: If the name of the limited liability company in the jurisdiction of organization is unavailable pursuant to 31 MRSA §1508, the fictitious name under which it seeks authority to conduct activities in the State of Maine is: (If not applicable, so indicate.) ______________________________________________________________________________________________ Form MLLC-5 accompanies this application. (See 31 MRSA § 1624.1) THIRD: Date of formation: ________________________ Jurisdiction where formed: _______________________________ Address of the principal office, wherever located: _________________________________________________________________________________________ (physical location - street (not P.O. Box), city, state and zip code) _________________________________________________________________________________________ (mailing address if different from above) FOURTH: The foreign limited liability company is a foreign limited liability company as defined in 31 MRSA §1502.11. FIFTH: The nature of the business or purpose(s) to be conducted or promoted in the State of Maine is: __________________________________________________________________________________________. Form No. MLLC-12 (1 of 3) American LegalNet, Inc. www.FormsWorkFlow.com SIXTH: The Registered Agent is a: (select either a Commercial or Noncommercial Registered Agent) Commercial Registered Agent CRA Public Number: ____________________ __________________________________________________________________________________ (name of commercial registered agent) Noncommercial Registered Agent __________________________________________________________________________________ (name of noncommercial registered agent) __________________________________________________________________________________ (physical location, not P.O. Box street, city, state and zip code) __________________________________________________________________________________ (mailing address if different from above) SEVENTH: Pursuant to 5 MRSA §105.2, the registered agent listed above has consented to serve as the registered agent for this limited liability company. EIGHTH: The name and business, residence and mailing address of each manager (if any): NAME ____________________________________ ADDRESS ___________________________________________________ ____________________________________ ___________________________________________________ ____________________________________ ___________________________________________________ Names and addresses of additional managers are attached as Exhibit ____, and made a part hereof. NINTH: The date on which the foreign limited liability company commenced or expects to commence conducting activities in the State of Maine is _______________________________. TENTH: Check only if applicable This is a professional limited liability company qualified pursuant to 13 MRSA Chapter 22-A to provide the following professional services (see 13 MRSA, chapter 22-A for information on what constitutes professional services): ____________________________________________________________________________________________ (type of professional services) Form No. MLLC-12 (2 of 3) American LegalNet, Inc. www.FormsWorkFlow.com ELEVENTH: (Check if applicable) The foreign limited liability company is governed by an agreement that establishes or provides for the establishment of designated series having separate rights, powers or duties with respect to specified property or obligations of the foreign limited liability company or profits and losses associated with specified property or obligations. Additional information required pursuant to MRSA 31 §1622.2.J are attached hereto as Exhibit _________, and made a part hereof. TWELFTH: This statement of qualification is accompanied by a certificate of existence or such other document that the Secretary of State determines to be suitable for purposes of proving the valid existence of the foreign limited liability company under the law of the State or other jurisdiction listed in item Third. The certificate or other document must not have been issued more than 90 days before the delivery of this statement to the office of the Secretary of State. Dated ______________________________ ___________________________________________________ (Authorized Signature**) ___________________________________________________ (Type or print name and capacity) *The limited liability company name as used in the State of Maine must contain one of the following: "limited liability company" or "limited company" or the abbreviation "L.L.C.," "LLC," "L.C." or "LC" or, in the case of a low-profit limited liability company, "L3C" or "l3c" see 31 MRSA 1508). If the limited liability company's name in its jurisdiction of organization complies with 31 MRSA § 1508 with the addition of these words, then no fictitious name filing is required pursuant to 31 MRSA §§ 1622.2.A and 1624.1. **Statement MUST be signed by at least one authorized person (31 MRSA §1676.1B). The execution of this statement 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 For
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