Free 26237.PDF - Indiana

APPLICATION FOR RENEWAL OF RESERVATION OF EXCLUSIVE USE OF A CORPORATE NAME
Sta te Form 2 6237 (R6 / 1-03) Approved by the State Board of Accounts, 1995

TO DD RO KITA SECRETARY OF STATE CO RP ORATIONS DIVISION 302 W. Washington St., Rm. E0 18 Ind ianap olis, IN 46204 Te lephon e: (31 7) 2 32-65 76 India na Cod e 2 3-1-23 -2

INSTRUCTIONS:

Use 8 1/2" x 11" white paper for attachments. Present original and one (1) copy to address in upper right corner of this form. Please TYPE or PRINT. Please visit our office on the web at www.sos.in.gov.

FILING FEE $20.00

Reserved Corporate name Date of Original Reservation Date of last application for Renewal of Reservation Name of applicant / owner * Address of applicant (number and street, city, state, ZIP code)

IN WITNESS WHEREOF, the undersigned executes this Application and verifies, subject to penalties of perjury, that the statements contained herein are true, this day of Signature Printed name , 20 .

* The applicant is the owner of the reserved name. The owner is the only person who may use the name or transfer the reservation pursuant to IC 23-23-2(b).