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Please remit your payment made payable to the Maine Secretary of State. Submit completed form to: Secretary of State.9(a) Notification of action taken, ECOA notice, and statement of specific reasons. Part I - Principal Reason(s) for Credit Denial, Termination, or Other Action Taken Concerning Credit. This section must be completed in all instances. Office of the Minnesota Secretary of State. Statement of Denial. Complete and include this form with your paper submission. This information only will be used to communicate in writing about the submission, if needed. 4 Delay, Denial, or Termination of Assistance .