F0018 - Page 1 of 1
OFFICE OF THE MISSISSIPPI SECRETARY OF STATE
P.O. BOX 136, JACKSON, MS 39205-0136 (601) 359-1333
*0018-1-1*
1. Type of Corporation (`X' in one only)
Mississippi Profit
Transfer of Reserved Name
Mississippi Nonprofit
Mississippi Limited Partnership
Foreign Limited Partnership
Foreign Profit
Foreign Nonprofit
2. Name reserved
3. Owner of reserved corporate name
4. Transferred to
5. Address Address City, State, ZIP5, ZIP4
(Please keep writing within blocks)
Signature of Owner/ Applicant
Rev. 01/96