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OFFICE OF THE MISSISSIPPI SECRETARY OF STATE
P.O. BOX 136, JACKSON, MS 39205-0136 (601) 359-1633
Mississippi LLC Application for Name Reservation
1. Type of Corporation
Mississippi Limited Liability Company Mississippi Professional Limited Liability Company
Foreign Limited Liability Company
Foreign Professional Limited Liability Company
2. Limited Liability Company name to reserve
3. Name of applicant
4. Address
City, State, ZIP5, ZIP4 5. Dated
-
By:
Signature
(Please keep writing within blocks)
Printed Name
Rev. 01/96