DO NOT WRITE ABOVE THIS LINE; RESERVED FOR ACC USE ONLY.
APPLICATION TO RESERVE LIMITED LIABILITY COMPANY NAME
Read the Instructions
1. NAME TO BE RESERVED
– see Instructions L001i
for name requirements for different entity
types. Enter the exact name or exact fictitious name to be reserved:
_______________________________________________________________________
2. TYPE OF ENTITY
–
check only one
to indicate the type of entity that may be formed:
LIMITED LIABILITY COMPANY
PROFESSIONAL LIMITED LIABILITY COMPANY
3. APPLICANT
– name
and address of the individual or entity that will own the name reservation:
Name
Address 1
Address 2 (optional)
City State or Province Zip
Country
SIGNATURE
:
I ACCEPT
Signature
Printed Name
Date (mm/dd/yyyy)
REQUIRED
–
check only one:
I am the
Applicant
(I am an individual or
natural person and not an entity).
The
Applicant is an entity
and I am its duly
authorized agent.
Filing Fee: $10.00 (regular processing)
Expedited processing – add $35.00 to filing fee.
All fees are nonrefundable - see Instructions.
Mail: Arizona Corporation Commission
Corporate Filings Section
1300 W. Washington St., Phoenix, Arizona 85007
Fax: 602-542-4100
Please be advised that A.C.C. forms reflect only the minimum provisions required by statute. You should seek private legal counsel for those matters that may pertain
to the individual needs of your business.
All documents filed with the Arizona Corporation Commission are public record and are open for public inspection.
If you have questions after reading the Instructions, please call 602-542-3026 or (within Arizona only) 800-345-5819.
L001.001 Arizona Corporation Commission – Corporations Division
Rev: 2010 Page 1 of 1
L001i
By checking the box marked "I accept" below, I acknowledge under penalty of perjury
that this document together with any attachments is submitted in compliance with
Arizona law.
