Application For Use Of Indistinguishable Name {MLLC-15}

Filing Fee $35.00 LIMITED LIABILITY COMPANY STATE OF MAINE APPLICATION FOR THE USE OF AN INDISTINGUISHABLE NAME _____________________ Deputy Secretary of State A True Copy When Attested By Signature ______________________________________ (Name of Limited Liability Company Allowing Indistinguishable Name) _____________________ Deputy Secretary of State Pursuant to 31 MRSA §1508.4, the undersigned limited liability company executes and delivers the following Application for the Use of an Indistinguishable Name: FIRST: The above-named limited liability company hereby consents to the use of the following indistinguishable name: ______________________________________________________________________________________________ to ____________________________________________________________________________________________. (requestor of indistinguishable name) SECOND: THIRD: The entity in possession of the name undertakes to change its name to a name that is distinguishable on the records of the Secretary of State from the name of the applicant. The entity in possession of the name must change its name to:* ______________________________________________________________________________________________. **Authorized person(s) Dated ________________________________ ___________________________________________________ (Signature) ___________________________________________________ (Type or print name and capacity) ___________________________________________________ (Signature) ___________________________________________________ (Type or print name and capacity) *This application must be accompanied by the applicable form to change the name as provided in Item Third. **Pursuant to 31 MRSA §1676.1B, this statement MUST be signed by a person authorized by the limited liability company. The execution of this certificate 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. MLLC-15 7/1/2011 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