Free SECRETARY OF STATE - South Dakota

Secretary of State Office 500 E Capitol Ave Pierre, SD 57501 (605)773-4845

APPLICATION FOR RESERVATION OF NAME
BUSINESS CORPORTION
Please Type or Print Clearly in Ink

Clear Form

Please submit one Original and one Photocopy

HELP
Telephone # ____________________ FAX # _______________________

FILING FEE: $25 payable to SECRETARY OF STATE

Pursuant to the provisions of the South Dakota Law, the undersigned hereby applies for reservation of the following name for a period of one hundred twenty (120) days, which period shall not be extended.
1. The name to be reserved is _______________________________________________________________________ ______________________________________________________________________________________________ Note: The name must include the term corporation, incorporated, company, limited or the applicable abbreviation. 2. Check one to indicate how the reserved name is to be used: Incorporation of a domestic business Domestic corporation intending to change its name

Foreign corporation intending to make application for a Certificate of Authority Foreign corporation authorized in this state intending to change its name Any person intending to organize a foreign corporation and to have such corporation make application for a Certificate of Authority

Dated ____________________________

______________________________________________
(Signature of the applicant)

______________________________________________
(Printed Name)

______________________________________________
(Title)

______________________________________________
(Address)

______________________________________________
(City) (State) (ZIP+4)

reservationofname July 2009