Fill and Sign the Caregivers America Timesheet Form

Certificate of Limited Partnership pursuant to 31 MRSA §1321 to accompany the following: ("X" one box only.) Articles of Entity Conversion (13-C MRSA §955.1) Articles/Certificate of Merger or Share Exchange (13-C MRSA §1106, 31 MRSA §744, 31 MRSA §1436) Certificate of Inter-Entity Consolidation (31 MRSA §744) Articles/Certificate of Conversion (31 MRSA §746, 31 MRSA §1432) Articles of Conversion of Partnership (31 MRSA §1093) FIRST: The name of the limited partnership is: ______________________________________________________________________________________________. (The name must contain one of the following: "Limited Partnership", "L.P." or "LP"; see 31 MRSA §1308.1.A.2.) SECOND: The street and mailing address of the limited partnership’s designated office shall be: _______________________________________________________________________________________________ (physical location - street (not P.O. Box), city, state and zip code) _______________________________________________________________________________________________ (mailing address if different from above) THIRD: The Registered Agent is a: (select either a Commercial or Noncommercial Registered Agent) Commercial Registered Agent CRA Public Number: ____________________ __________________________________________________________________________________ (name of commercial registered agent) Noncommercial Registered Agent __________________________________________________________________________________ (name of noncommercial registered agent) __________________________________________________________________________________ (physical location, not P.O. Box – street, city, state and zip code) __________________________________________________________________________________ (mailing address if different from above) FOURTH: Pursuant to 5 MRSA §108.3, the registered agent as listed above has consented to serve as the registered agent for this limited partnership. Form No. MLPA-6 -1 (1 of 2) FIFTH: The name, street and mailing address of each general partner is: Name Address ____________________________________ ___________________________________________________ ____________________________________ ___________________________________________________ ____________________________________ ___________________________________________________ Names and addresses of additional general partners are attached as Exhibit ____, and made a part hereof. SIXTH: Check only if applicable The limited partnership is a limited liability limited partnership. (If checked, the name in Item First must contain one of the following: "Limited Liability Limited Partnership", "L.L.L.P." or "LLLP" and cannot contain the abbreviation of “L.P” or “LP”; see 31 MRSA §1308.1.A.3) SEVENTH: Check only if applicable This is a professional limited liability limited partnership* formed pursuant to 31 MRSA §1354.4 to provide the following professional services: (see 13 MRSA, chapter 22-A for information on what constitutes professional services) ____________________________________________________________________________________________ ____________________________________________________________________________________________ (type of professional services) EIGHTH: Other provisions of this certificate, if any, that the partners determine to include OR any additional information as required by 31 MRSA subchapter 11 are set forth in the attached Exhibit ______ and made a part hereof. *In addition to the requirements in Item Sixth, the name must contain one of the following: “chartered”, “professional association” or “service” or the abbreviation “P.A.”. In lieu of requirements in Item Sixth, the name must contain one of the following: “professional limited liability limited partnership” or abbreviation “PLLLP” or P.L.L.L.P.,” or “S.L.L.L.P”. Examples of professional services are accountants, attorneys, chiropractors, dentists, registered nurses and veterinarians. (This is not an inclusive list – see 13 MRSA §723.7.) Form No. MLPA-6 -1 (2 of 2) Rev. 7/1/2008 Filer Contact Cover Letter To: Department of the Secretary of State Division of Corporations, UCC and Commissions 101 State House Station Augusta, ME 04333-0101 Tel. (207) 624-7752 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 service ($50 additional filing fee per entity, per service) Expedited filing - Immediate service ($100 additional filing fee per entity, per service) Total filing fee(s) enclosed: $ ________________ Contact Information – questions regarding the 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 State’s office) ___________________________________ ___________________________________ (Name of contact person) (Daytime telephone number) ____________________________________________________ (Email address) The enclosed filing(s) and fee(s) are submitted for filing. Please return the attested copy to the following address: ______________________________________________________________________________ (Name of attested recipient) _____________________________________________________________________________________________ (Firm or Company) _____________________________________________________________________________________________ (Mailing Address) _____________________________________________________________________________________________ (City, State & Zip)