APPLICATION FOR
Secretary of State Office
500 E Capitol Ave
Pierre, SD 57501
(605)773-4845
RESERVATION OF NAME
NONPROFIT CORPORATION
Please Type or Print Clearly in Ink
Please submit one Original and one Photocopy
FILING FEE: $25 payable to SECRETARY OF STATE
Telephone # ____________________
FAX # _______________________
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 _______________________________________________________________________
______________________________________________________________________________________________
2. Check one to indicate how the reserved name is to be used:
Incorporation of a domestic nonprofit corporation
Domestic nonprofit corporation intending to change its name
Foreign nonprofit corporation intending to make application for a Certificate of Authority
Foreign nonprofit corporation authorized in this state intending to change its name
Any person intending to organize a foreign nonprofit 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)
reservationofnonprofitname April 2012
