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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.