Form Mllp-11r - Form For A Certificate Of Renunciation - Domestic Limited Liability Partnership Page 2

DATED

AU11IORIZED SIGNA TURE(S)*

(signature)

(type or print name and capacity)

For Authorized Signature(s) on behalf of Entities

Name of Entity

(audlorized signature)

(type or print name and capacity)

Name of Entity

(authorized signattlre)

(tyPe or print l1ame and capacity)

*Certificate MUST be signed by

(I)

if the partners are winding up the registered limited liability partnership's affairs, then by the contact partner or by a

majority in interest of the partners OR

(2)

if the partners are not winding up the registered limited liability partnership's affairs, then by all liquidating trustees OR

(3)

any duly authorized person.

The execution of this certificate constitutes an oath or affIrmation under the penalties of false swearing under Title 17-A, section 453.

SUBMIT COMPLETED FORMS TO: CORPORATE EXAMINING SECTION, SECRETARY OF STATE,

101 STATE HOUSE STATION, AUGUSTA, ME 04333-0101

FORM NO. MLLP-IIR

Rev.8/2000

TEL. (201) 287-4195

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Parent category: Legal