Free CORPF6D1932.WPD - Nebraska

APPLICATION FOR RESERVATION OF CORPORATE NAME
John A. Gale, Secretary of State Room 1301 State Capitol, P.O. Box 94608 Lincoln, NE 68509 http://www.sos.state.ne.us Submit in Duplicate The undersigned hereby requests that the following name be reserve d. Name to be Reserved_____________________________________________________ Reservation is good for 120 days and is not renewable.

DATED__________________________

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Signature

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Printed Name/Title

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Street Address

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City, State, Zip NOTE: Every filing must be signed by the chairperson of the board of directors, the president, or one of the officers of the corporation. If the corporation has not yet been formed or directors have not yet been selected, the filing shall be signed by an incorporator. If the corporation is in the hands of a receiver, trustee, or other court appointed fiduciary, the filing shall be signed by that fiduciary.

FILING FEE: $30.00

Revised 12/19/2000

Neb. Rev. Stat. 21-1932 & 21-2029