Form Mnpca-11 - Statement Of Intent To Dissolve Page 2

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DATED
*By
(signature)
(tyPe or print name aixl capacity)
*By
( signattlre )
(type or print name aOO capacity)
Notice of the rIling of this statement shall be mailed to each known creditor of the corporation and to the State Tax Assessor
pursuant to 13-B MRSA §1101.2.
*This document ~
be signed by
(I) the ~
or Secretarv OR
(2) the President or a vice-pres. together with the Secretarv 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-ll
Rev.7/2000
TEL. (201) 287-4195

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