APPLICATION TO RESERVE A CORPORATE NAME

Pursuant to ________________________________________ (state statute), the undersigned hereby applies to the Secretary of State to reserve the following corporate name:

1. The corporate name to be reserved is ____________________________________
____________________________________________________________________

2. The name of the applicant is: ___________________________________________
____________________________________________________________________

3. The address of the applicant is: __________________________________________
____________________________________________________________________

4. The above corporate name is to be reserved for a non-renewable

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