Free c156ds110695011337.indd - Massachusetts

DF PC

The Commonwealth of Massachusetts
William Francis Galvin Secretary of the Commonwealth One Ashburton Place, Boston, Massachusetts 02108-1512

FORM MUST BE TYPED

(General Laws Chapter 156D, Section 11.06; 950 CMR 113.37)
Exact name, jurisdiction and date of organization of each party to the merger: (1) EXACT NAME (2) JURISDICTION

Articles of Merger FORM MUST BE TYPED Involving Domestic Corporations, Foreign Corporations or Foreign Other Entities

DATE OF ORGANIZATION

____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ (3) The foreign corporation or other entity ®is /®is not* authorized to conduct business in the Commonwealth.

(4) Exact name of the surviving entity: _____________________________________________________________________

(5) Jurisdiction under the laws of which the surviving entity will be organized: _______________________________________

(6) The merger shall be effective at the time and on the date approved by the Division, unless a later effective date not more than 90 days from the date and time of filing is specified: ________________________________________________________ (7-8) For each domestic corporation that is a party to the merger:** (check appropriate box) ® The plan of merger was duly approved by the shareholders, and where required, by each separate voting group as provided by G.L. Chapter 156D and the articles of organization. OR ® The plan of merger did not require the approval of the shareholders.

(9) Participation of each other domestic entity, foreign corporation, or foreign other entity was duly authorized by the law under which the other entity or foreign corporation is organized and by its organizational documents.

* Check appropriate box ** Provide this information for each domestic corporation separately
P.C.

c156ds110695011337 01/18/05

(10) Attach any amendment to articles of organization of the surviving entity, where the survivor is a domestic business corporation.

(11) Attach the articles of organization of the surviving entity, where the survivor is a NEW domestic business corporation, including all the supplemental information required by 950 CMR 113.16.

(12) State the executive office address of the surviving foreign other entity if such information is not on the public record in the foreign jurisdiction: ________________________________________________________________________________ (number, street, city or town, state. zip code)

Signed by: ___________________________________________________________________________________________ , (signature of authorized individual) ® Chairman of the board of directors, ® President, ® Other officer, ® Court-appointed fiduciary, on this _____________________________ day of _______________________________________ , __________________ .

Signed by: ___________________________________________________________________________________________ , (signature of authorized individual) ® Chairman of the board of directors, ® President, ® Other officer, ® Court-appointed fiduciary, on this _____________________________ day of _______________________________________ , __________________ .

COMMONWEALTH OF MASSACHUSETTS
Secretary of the Commonwealth One Ashburton Place, Boston, Massachusetts 02108-1512

William Francis Galvin

Articles of Merger Involving Domestic Corporations, Foreign Corporations or Foreign Other Entities
(General Laws Chapter 156D, Section 11.06; 950 CMR 113.37)
I hereby certify that upon examination of these articles of merger, duly submitted to me, it appears that the provisions of the General Laws relative thereto have been complied with, and I hereby approve said articles; and the filing fee in the amount of $______ having been paid, said articles are deemed to have been filed with me this day of ___________ 20 ______________ at a.m./p.m. time Effective date: _________________________________________________ (must be within 90 days of date submitted)

WILLIAM FRANCIS GALVIN
Secretary of the Commonwealth Filing fee: Minimum $250
Examiner Name approval

TO BE FILLED IN BY CORPORATION
C #A.R.

Contact Information:

___________________________________________________________ ___________________________________________________________ ___________________________________________________________ Telephone: ___________________________________________________ Email: ______________________________________________________ Upon filing, a copy of this filing will be available at www.sec.state.ma.us/cor. If the document is rejected, a copy of the rejection sheet and rejected document will be available in the rejected queue.