Massachusetts Corporation Merger of Domestic and Foreign Entities Form

In the case of domestic and foreign wanting to form a merger together in the State of Massachusetts, the Massachusetts Corporation Merger of Domestic and Foreign Entities Form has to be completed and submitted along with a $250 filing fee.

Extracted Text for Proper Search

FORM MUST BE TYPEDFORM MUST BE TYPED	
The Commonwealth of Massachusetts	
William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place, Boston, Massachusetts 02108-1512	
c156ds110695011337 	01/18/05	P.C.
DF
PC	
Articles of Merger 	
Involving Domestic Corporations, 	
Foreign Corporations or Foreign Other Entities
(General Laws Chapter 156D, Section 11.06; 950 CMR 113.37)	
Exact name, jurisdiction and date of organization of each party to the merger:
(1) EXACT NAME  (2) JURISDICTION  DATE OF ORGANIZATION
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
(3)  Th  e foreign corporation or other entity 	®is /	®is not* authorized to conduct business in the Commonwealth.	
(4)  Exact name of the surviving entity:	  _____________________________________________________________________	
(5)  Jurisdiction under the laws of which the surviving entity will be organized:	 _______________________________________	
(6)  Th  e merger shall be eff ective at the time and on the date approved by the Division, unless a later eff ective date not more than 	
90 days from the date and time of fi ling is specifi ed:	  ________________________________________________________	
(7-8) For each domestic corporation that is a party to the merger:**	
(check appropriate box)
®  Th  e plan of merger was duly approved by the shareholders, and where	 required, by each separate voting group as pro-	
vided by G.L. Chapter 156D and the articles of organization.	
OR
®   Th  e plan of merger did not require the approval of the shareholders.	
(9)  Participation of each other domestic entity, foreign corporation, or foreign other entity was duly authorized by the law under 	
which the other entity or foreign corporation is organized and by its organizational documents.	
* Check appropriate box
** Provide this information for each domestic corporation separately

(10) Attach any amendment to articles of organization of the surviving entity, where the survivor is a domestic business corpora-
	
tion.
	
(11) Attach the articles of organization of the surviving entity, where the survivor is a NEW domestic business corporation, in-
	
cluding all the supplemental information required by 950 CMR 113.16.
	
(12) State the executive offi  ce address of the surviving foreign other entity if such information is not on the public record in the 
	
foreign jurisdiction:  
	 ________________________________________________________________________________
	
   
	(number, street, city or town, state. zip code)

Signed by:
	  ___________________________________________________________________________________________
	,
	
 (signature of authorized individual)
	
®
  Chairman of the board of directors,

®
  President,

®
  Other offi  cer,

®
  Court-appointed fi duciary,
	
on this
	  _____________________________
	day of
	 _______________________________________
	day of	 _______________________________________	day of
	, 
 __________________
	.
	
Signed by:
	  ___________________________________________________________________________________________
	,
	
 (signature of authorized individual)
	
®
  Chairman of the board of directors,

®
  President,

®
  Other offi  cer,

®
  Court-appointed fi duciary,
	
on this
	  _____________________________
	day of
	 _______________________________________
	day of	 _______________________________________	day of
	, 
 __________________
	.

Examiner

Name approval

C

#A.R.
	
COMMONWEALTH OF MASSACHUSETTS
	
William Francis Galvin

Secretary of the Commonwealth
	
One Ashburton Place, Boston, Massachusetts 02108-1512
	
Articles of Merger Involving Domestic Corporations, 
	
Foreign Corporations or Foreign Other Entities

(General Laws Chapter 156D, Section 11.06; 950 CMR 113.37)
	
I  hereby  certify  that  upon  examination  of  these  articles  of  merger,  duly  submitted 

to me, it appears that the provisions of the General Laws relative thereto have been 

complied with, and I hereby approve said articles; and the fi ling fee in the amount of 

$______ having been paid, said articles are deemed to have been fi led with me this 

day of
	 ___________
	day of	 ___________	day of
	20
  ______________
	at
	a.m./p.m.
	
  time

Eff ective date:
	 _________________________________________________
	
 (must be within 90 days of date submitted)
	
WILLIAM FRANCIS GALVIN
	
Secretary of the Commonwealth

Filing fee: Minimum $250
	
TO BE FILLED IN BY CORPORATION
	
Contact Information:
	
___________________________________________________________

___________________________________________________________

___________________________________________________________

Telephone:
	 ___________________________________________________
	
Email:
	  ______________________________________________________
	
Upon fi ling, a copy of this fi ling will be available at www.sec.state.ma.us/cor. If the 

document  is  rejected,  a  copy  of  the  rejection  sheet  and  rejected  document  will  be 

available in the rejected queue.