STATE OF SOUTH CAROLINA SECRETARY OF STATE APPLICATION TO RESERVE CORPORATE NAME
TYPE OR PRINT CLEARLY WITH BLACK INK
1. Pursuant to Section 33-4-102 (a) of the 1976 South Carolina Code of Laws, as amended, the undersigned hereby applies to the Secretary of State to reserve the following corporate name
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for a period of one hundred twenty days from the date of filing this application. 2. Name, address and signature of the applicant
Name
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Street
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City
State
Zip Code
Date
Name Reserved
Signature
Print Name
FILING INSTRUCTIONS 1. Two copies of this form, the original and either a duplicate original or a conformed copy, must by filed. Include a selfaddressed envelope for quicker return. Filing Fee (payable to the Secretary of State at the time of filing this document) - $10.00 Return to: Secretary of State P.O. Box 11350 Columbia, SC 29211 NOTE THIS RESERVATION EXPIRES 120 DAYS FROM THE DATE OF FILING. REGISTERING YOUR CORPORATE NAME DOES NOT, IN AND OF ITSELF, PROVIDE AN EXCLUSIVE RIGHT TO USE THAT NAME ON OR IN CONNECTION WITH ANY PRODUCT OR SERVICE. USE OF A NAME AS A TRADEMARK OR SERVICE MARK WILL REQUIRE FURTHER CLEARANCE AND REGISTRATION AND BE AFFECTED BY PRIOR USE OF THE MARK. FOR MORE INFORMATION, CONTACT THE TRADEMARKS DIVISION OF THE SECRETARY OF STATE'S OFFICE AT (803) 734-1728.
DOM-APP TO RESERVE A CORPORATE NAME.doc
2.
Form Revised by South Carolina Secretary of State, January 2000