Form Cony - Certificate Of Conversion - Maine Secretary Of State

Form Cony - Certificate Of Conversion - Maine Secretary Of State - 2000

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STATE OF MAINE

CERTIFICATE OF CONVERSION

Deputy Secretary of State

Pursuant to 13-A MRSA §912 or, if applicable, 31 MRSA

§418 and 31 MRSA §746, the required number of shareholders

and/or owners of the undersigned business entity approved a

plan of conversion and the undersigned business entity adopts

the following Certificate of Conversion:

A True Copy When

Attested

By Signature

Deputy Secretary of State

FIRST:

The date on which the business entity fIrst came into being is

and its jurisdiction

immediately prior to its conversion is

SECOND:

The name of the converting business entity is

TIDRD:

The name of the resulting business entity is

FOURm:

The plan of conversion is on fIle at the principal place of business of the resulting business entity .A

copy of the plan

of conversion will be furnished by the resulting business entity , on request and without cost, to any interest holder of

the business entity .The address of such place of business is as follows:

I!'D'l'H:

(I)

If the converting business entity is a corporation,

complete the following:

Name of

Corooration

Designation and Number

of Shares Outstanding

Number of Shares

Entitled to Vote

NUMBER

Voted For

NUMBER

Voted Against

(2)

If the shares of any class were entitled to vote as a class, complete the following:

Name of

Co!:RQration

Number of Shares

Outstandinl!

NUMBER

VoteQ For

NUMBER

Voted

Against

Designation

of Class

The number of votes cast for the plan in (I) or (2) above, were sufficient for approval of the plan by the

shareholders or by that class of shareholders.

SIXTH:

Effective date of the conversion (if other than date of fIling of the Certificate) is

(Not to exceed 60 days from date of filing of the Certificate)

SEVENTH:

All of the statements required to be set forth in the organizing documents for the resulting business entity are attached

as Exhibit -.The

appropriate form (CONV-BUS Articles of Incorporation), (CONY-LP Certificate of Limited

Partnership) or (CONY -LLC Articles of Organization of Limited Liability Company) must be attached.

Form Cony - Certificate Of Conversion - Maine Secretary Of State - 2000

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