Form Mnpca-10a - Domestic Nonprofit Corporation Articles Of Consolmation Page 2

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FOURTH:
The address of the registered office in the State of Maine of
is
(street. city, state aIxl zip code)
The address of the registered office in the State of Maine of
is
(street, city, state and zip code)
FIFTH:
Effective date of the consolidation (if later than date of filing of Articles) is
(Not to exceed 60 days from date of filing of the Articles)
DATED
(name
of
corporation)
*By
(signattlre)
(type or print name and capacity)
*By
(signature)
(type or print name aOO capacity)
DATED
(name of corporation)
"'Hy
(signature)
(type or print name arxl capacity)
*By
(signature)
(type or print name aOO capacity)
TInS FORM MJ1H BE ACCOMPANIED
BY FORM MNPCA-18 (Acceptance of Appointment as Registered Agent §304.3.).
*This document MUST be signed by
(I) the ~
or Secretary OR
(2) the President or a vice-pres. together with the Secretary or an ass't. sec., or a 2nd certifying officer OR
(3) if no such officers, then a majority of the Directors OR
(4) if no such directors, then the Members.
SUBMIT COMPLETED FORMS TO: CORPORATE EXAMINING SECTION, SECRETARY OF STATE,
101 STATE HOUSE STATION, AUGUSTA, ME 04333-0101
FORM NO. MNPCA-10A Rev.7/2000
TEL. (207} 287-4195

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