Maine LLC Merger Form

In the case of 2 or more companies wanting to merge together in the State of Maine, the Maine LLC Merger Form has to be completed and submitted.

Extracted Text for Proper Search

_____________________ 
Deputy Secretary of State	 	
 
 	
A True Copy When Attested By Signature 	
 
 	
_____________________ 
Deputy Secretary of State 	
                       Filing Fee $150.00 
 	
 	 	 
LIMITED LIABILITY COMPANY   
 
STATE OF MAINE  
 
 
STATEMENT OF MERGER 
                       (Relating to a LLC) 
 
 
 	
 
 
   
 
 
 
 
 
 
 
 
 	
 
 
 
 
 
 
 
 
Pursuant	

 to 31 MRSA §1641 , the undersigned survivor of the merger executes and delivers the following Statement of Merger: 
 
FIRST:    Constituent Organiz	

ations that are Parties to the Merger: 
 
  Name	
                          Form of Organization	                    Jurisdiction	              Date of Organization	 
 
  ______________________________________________________________________\
_________________________ 
 
  ______________________________________________________________________\
_________________________ 
 
  ______________________________________________________________________\
_________________________ 
 
  ______________________________________________________________________\
_________________________ 
  	
 	
  	  Name, form, jurisdiction and date of organization of additional limited liability companies or other constituent 
organizations are attached as Exhi bit ____, and made a part hereof. 
 
SECOND:  Surviving Organization : 
   
  Name of surviv ing organization: ___________________________________________________________________ 
 
    Form of surviving organization: _____________________________________    
 
    Jurisdiction of governing statute: _____________________    Date of its organization: _________________________ 
  
  Address of its  principal office: ______________________________________________________________________ \
 
 
THIRD:    (Check only one box) 
 
  
  The surviving organization is created by this merger.   The organizational document that creates this 
surviving organization is attached;  or 
 
  
  The surviving organization existed before the merger.  (Check only one box below) 
    	
   Amendments provided for in the plan of merger for the organizational document that created the 
                                       surviving organization that are in  the public record are attached; or 
 
  
    The organizational documents remain unchanged. 
 
 
Form No. MLLC-10 (1 of 3)

FOURTH:   Date the merger is effective under the govern ing statute of the surviving organization: ________________________ 
 
 
FIFTH:   The merger was approved as required by each constituent organization’s govern ing statute and as required by the 
organizational documents of each constituent or ganization that is party to this merger. 
 
SIXTH:    (Foreign Surviving Organization Only) 
The surviving foreign organization acknowledges it may be served with process in this State by certified mail and the 
address of its principal office	
 for the purpose of  §1644.2 is: 
 
    ____________________________________________________________________\
 
        
    ____________________________________________________________________\
 
 
 
SEVENTH:  Additional inform	
ation required  by the governing statute of any constituent or ganization is set forth in the attached 
Exhibit _____, and made a part hereof.  
 
 	
Must Be Completed By the First Co nstituent Organization to the Merger 	
 
 
________________________________________________________________________\
____ _____________________________ 
      (Name and form of participating constituent organization)                  (Date) 
 
___________________________________________________   ___________________________________________ 
         (*Authorized signature)                (Type or print name and capacity) 
 
___________________________________________________   ___________________________________________ 
         (*Authorized signature)                (Type or print name and capacity) 
 
 	
 
Must Be Completed By the Second Cons tituent Organization to the Merger 
 	
 
________________________________________________________________________\
____ _____________________________ 
      (Name and form of participating constituent organization)                   (Date) 
 
___________________________________________________   ___________________________________________ 
         (*Authorized signature)                (Type or print name and capacity) 
 
___________________________________________________   ___________________________________________ 
         (*Authorized signature)                (Type or print name and capacity) 
 	
 
Must Be Completed By the Third Cons tituent Organization to the Merger 	
 
 
________________________________________________________________________\
____ _____________________________ 
      (Name and form of participating constituent organization)                   (Date) 
 
___________________________________________________   ___________________________________________ 
         (*Authorized signature)                (Type or print name and capacity) 
 
___________________________________________________   ___________________________________________ 
         (*Authorized signature)                (Type or print name and capacity) 
 
Form No. MLLC-10 (2 of 3)

Must Be Completed By the Fourth Co nstituent Organization to the Merger 	
 
 
________________________________________________________________________\
____ _____________________________ 
      (Name and form of participating constituent organization)                   (Date) 
 
___________________________________________________   ___________________________________________ 
         (*Authorized signature)                (Type or print name and capacity) 
 
___________________________________________________   ___________________________________________ 
         (*Authorized signature)                (Type or print name and capacity) 
 
 
(Copy this page, and modify participant number,  if more signature spaces are needed.) 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
*Pursuant

 to 31 MRSA  §§1643.1 and 1676.1, this statement of merger must be signe d by a person authorized by each constituent 
o	

rganization that is party to this merger. 
 
The execution of this certificate cons titutes an oath or affirmation, under the penalties of false swearing under 17-A MRSA §453. 
 
Pl	

ease remit your payment made payabl e to the Maine Secretary of State. 
 
Submit completed form to:     Secretary of State 
    Division of Corp orations, UCC and Commissions 
    101 State House Station 
    Augusta, ME  04333-0101 
     Telephone Inquiries:   (207) 624-7752 Email Inquiries:  [email protected]  
   
 
 
 
 
 
Form	

 No. MLLC-10 (3 of 3) 7/1/2011

Filer Contact Cover Letter	
 
 
 
 
 
To:  Department of the Secretary of State            Tel. (207) 624-7752 
  Division of Corporatio ns, UCC and Commissions 
  101 State House Station 
  Augusta, ME 04333-0101   
 
 
Name of Entity (s): 
 _______________________________________________________________________ \
	
 	
_______________________________________________________________________ \
	
 
List type of filing(s) enclosed 	(i.e. Articles of Incorporation, Articles of  Merger, Articles of Amendment, Certificate 
of Correction, etc.) Attach additional pages as needed.	
 
 
________________________________________________________________________\
 
  ________________________________________________________________________\
 	
  	
Special handling request(s): 	(check all that apply)	 
 
 	
  Hold for pick up 
 
  Expedited filing - 24 hour se rvice ($50 additional filing fee per entity, per service) 
  Expedited filing - Immediate service ($100 a dditional filing fee per entity, per service) 
 
Total filing fee(s) enclosed:  $ ________________ 
 
Contact Information – questions regarding th e above filing(s), please call or email: 	
(failure to provide a 
contact name and telephone number or email address will result in the return of the erroneous filing (s) by the Secretary of St ate’s office) 	
 
___________________________________   ___________________________________ 	
(Name of contact person) 	    	(Daytime telephone number) 
 	
 
____________________________________________________ 	
(Email address) 
 	
The enclosed filing(s) and fee(s) are submitted for f iling. Please return the attested copy to the following 
address:  
 
________________________________________________________________________\
______ 	
(Name of attested recipient) 
 	
_____________________________________________________________________________________________ 	
(Firm or Company) 
 	
_____________________________________________________________________________________________ 	
(Mailing Address) 	
 
_____________________________________________________________________________________________ 	
(City, State & Zip)