Form Cons - Articles/certificate Of Inter-Entity Consolidation Page 4

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(MUST BE COMPLETED BY THE SECOND PARTICIPANT TO THE CONSOLIDATION)
_______________________________________________________________________
______________________________
Name and Type of Participating Business Entity
Dated
____________________________________________________
_____________________________________________
Authorized Signature
Type or Print Name and Capacity
____________________________________________________
_____________________________________________
Authorized Signature
Type or Print Name and Capacity
(MUST BE COMPLETED BY THE SECOND PARTICIPANT ONLY IF IT IS A CORPORATION)
The address of the registered office, including the street, city, state and zip code, in the State of Maine is as follows:
________________________________________________________________________________________________________________
(MUST BE COMPLETED BY THE SECOND PARTICIPANT ONLY IF IT IS A DOMESTIC CORPORATION)
The undersigned clerk, secretary or assistant secretary certifies that he/she has custody of the minutes showing the above action by the
shareholders.
____________________________________________________
_____________________________________________
Authorized Signature
Type or Print Name and Capacity
(MUST BE COMPLETED BY THE THIRD PARTICIPANT TO THE CONSOLIDATION)
_______________________________________________________________________
______________________________
Name and Type of Participating Business Entity
Dated
____________________________________________________
_____________________________________________
Authorized Signature
Type or Print Name and Capacity
____________________________________________________
_____________________________________________
Authorized Signature
Type or Print Name and Capacity
(MUST BE COMPLETED BY THE THIRD PARTICIPANT ONLY IF IT IS A CORPORATION)
The address of the registered office, including the street, city, state and zip code, in the State of Maine is as follows:
________________________________________________________________________________________________________________
(MUST BE COMPLETED BY THE THIRD PARTICIPANT ONLY IF IT IS A DOMESTIC CORPORATION)
The undersigned clerk, secretary or assistant secretary certifies that he/she has custody of the minutes showing the above action by the
shareholders.
____________________________________________________
_____________________________________________
Authorized Signature
Type or Print Name and Capacity
(Copy this page, and modify participant number, if more signature spaces are needed.)
________________________________________________________________________________________________________________
SUBMIT COMPLETED FORMS TO: CORPORATE EXAMINING SECTION, SECRETARY OF STATE,
101 STATE HOUSE STATION, AUGUSTA, ME 04333-0101
FORM NO. CONS Rev. 4/16/2001
TEL. (207) 624-7740

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