Free MNPCA-15 - Maine

Filing Fee $5.00

NONPROFIT CORPORATION STATE OF MAINE

APPLICATION FOR THE USE OF AN INDISTINGUISHABLE NAME

_____________________ Deputy Secretary of State

A True Copy When Attested By Signature

______________________________________
(Name of Corporation Allowing Indistinguishable Name)

_____________________ Deputy Secretary of State

Pursuant to 13-B MRSA §301-A.4, the undersigned corporation executes and delivers the following Application for the Use of an Indistinguishable Name: FIRST: The above-named corporation 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:* ______________________________________________________________________________________________.

FOURTH:

The address of the registered office of the corporation allowing indistinguishable name in the State of Maine is ______________________________________________________________________________________________.
(street, city, state and zip code)

DATED _________________________

*By ___________________________________________________
(signature)

__________________________________________________
(type or print name and capacity)

*By ___________________________________________________
(signature)

__________________________________________________
(type or print name and capacity)

*This application must be accompanied by the applicable form to change its name as provided in Item Third. *This document MUST be signed by any duly authorized officer. (13-B MRSA §104.1.B)

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-15 (1 of 1) Rev.9/16/2005 TEL. (207) 624-7752