Free Form 5  Application for Registration of Corporate Name - New Hampshire

Please Note
Application for Registration of Corporation Name (Form 5) is ONLY used to protect the Names of Corporations that are NOT transacting business in New Hampshire. To qualify to do business in New Hampshire, you must file an Application for Certificate of Authority (Form 40).

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State of New Hampshire
Form 5 RSA 293-A:4.03 APPLICATION FOR REGISTRATION OF CORPORATE NAME (A FOR PROFIT FOREIGN CORPORATION)

Registration fee: $25.00 Use black print or type. Leave 1" margin both sides.

PURSUANT TO THE PROVISIONS OF THE NEW HAMPSHIRE BUSINESS CORPORATION ACT, THE UNDERSIGNED CORPORATION HEREBY APPLIES FOR THE REGISTRATION OF ITS CORPORATE NAME TO AND INCLUDING DECEMBER 3l, __ ___ AND SUBMITS THE FOLLOWING STATEMENT: FIRST: The name of the corporation is . SECOND: It is incorporated under the laws of THIRD: The date of its incorporation is FOURTH: It is carrying on or doing business. FIFTH: The business in which it is engaged is . .

. SIXTH: This Application is accompanied by: (a) a certificate setting forth that the corporation is in good standing under the laws of wherein it is incorporated, executed by the official having custody of the records pertaining to corporations in that state or territory; and (b) a registration fee of $25.00 as required by such Section 1.22. (Note 1)
(Note 2) (Corporation Name) (No.) (Street) (City/Town) (State) (Zip Code)

(Note 3)
(Telephone Number) (Signature) (Print or type name)

(Note 3)
(Title)

Date signed: Notes: 1. Fee is $25.00, between date of filing application and the next December 3l. 2. Exact corporate name and address of corporation making the application. 3. Signature and title of person signing for the corporation. Must be signed by the chairman of the board of directors, president or another officer; or see RSA 293-A:1.20(f) for alternative signatures. DISCLAIMER: All documents filed with the Corporate Division become public records and will be available for public inspection in either tangible or electronic form. Mail fee with DATED AND SIGNED ORIGINAL WITH ORIGINAL CERTIFICATE OF GOOD STANDING to: Corporate Division, Department of State, 107 North Main Street, Concord NH 033014989.
Form 5 [2/2009]