Free 26233.PDF - Indiana

APPLICATION FOR RESERVATION OF EXCLUSIVE USE OF CORPORATE NAME
State Form 2623 3 (R5 / 1-0 3) App roved by State B oard of Acco unts, 1 995

TODD ROKITA SE CRETARY OF STATE CORPORATIO NS DIVIS ION 302 W. Washing ton St., Rm. E018 Indian apolis, IN 462 04 Teleph one: (317 ) 2 32-657 6 India na Co de 23-1-23 -1 and 23-1-2 3-2

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

Pro posed name to be reserved

Name o f appl ican t

Add ress of ap plicant (nu mb er a nd street, city, state, ZIP co de)

Sign atu re of app lica nt

Prin ted na me of a pplicant

FOR USE BY SECRETARY OF STATE OFFICE ONLY

The name is available and reserved for 120 days from the date stamped on this application.

The name is indistinguishable from a name on the records of the Secretary of State and is therefore unavailable.

NOTE: The owner of the reserved name may transfer the reservation to another person by delivering to the Secretary of State a signed notice of the transfer. The notice must state the name and address of the transferee and the original approval date or have an attached copy of the original file-marked application for reservation of a corporate name.

NOTE: The Articles of Incorporation or Organization must have attached a copy of the file marked Application for Reservation of a Corporate Name.