_____________________
Deputy Secretary of State
A True Copy When Attested By Signature
_____________________
Deputy Secretary of State
Filing Fee $20.00
BUSINESS CORPORATION
STATE OF MAINE
APPLICATION FOR
RESERVATION OF NAME
Pursuant to 13-C MRSA §402.1, the undersigned applicant executes and delivers the following Application for Reservation of Name:
_____________________________________________________________________________________________________________
(Name to be reserved)
Name of applicant ______________________________________________________________________________________________
Address of applicant ____________________________________________________________________________________________
APPLICANT DATED
__________________________
__________________________________________________ ______________________________________________________
(signature of applicant) (type or print name and capacity)
Names are reserved for a period of 120 days and
may not be renewed
.
The Secretary of State will
not
act as an agent by holding applications for filing upon expiration of an existing reservation. Timely
filing is the responsibility of the applicant.
This application serves only as a reservation of the right to the use of a name. Actual use of the name
is not recommended
until the
purpose for which the name is reserved is completed.
Please remit your payment made payable to the Maine Secretary of State.
SUBMIT COMPLETED FORMS TO: CORPORATE EXAMINING SECTION, SECRETARY OF STATE,
101 STATE HOUSE STATION, AUGUSTA, ME 04333-0101
FORM NO. MBCA-1 7/1/2003
TEL. (207) 624-7752
Filer Contact Cover Letter
To: Department of the Secretary of State Tel. (207) 624-7752
Division of Corporations, UCC and Commissions
101 State House Station
Augusta, ME 04333-0101
Name of Entity (s):
_______________________________________________________________________
_______________________________________________________________________
List type of filing(s) enclosed (i.e. Articles of Incorporation, Articles of Merger, Articles of Amendment, Certificate
of Correction, etc.) Attach additional pages as needed.
________________________________________________________________________
________________________________________________________________________
Special handling request(s): (check all that apply)
Hold for pick up
Expedited filing - 24 hour service ($50 additional filing fee per entity, per service)
Expedited filing - Immediate service ($100 additional filing fee per entity, per service)
Total filing fee(s) enclosed: $ ________________
Contact Information – questions regarding the above filing(s), please call or email:
(failure to provide a
contact name and telephone number or email address will result in the return of the erroneous filing (s) by the Secretary of State’s office)
___________________________________ ___________________________________
(Name of contact person) (Daytime telephone number)
____________________________________________________
(Email address)
The enclosed filing(s) and fee(s) are submitted for filing. Please return the attested copy to the following
address:
______________________________________________________________________________
(Name of attested recipient)
_____________________________________________________________________________________________
(Firm or Company)
_____________________________________________________________________________________________
(Mailing Address)
_____________________________________________________________________________________________
(City, State & Zip)