Arizona Financial Institutions Division
Application for permission from AZDFI to use a prohibited name
Arizona Department of Financial Institutions, Financial Institutions Division 100 N. 15
Avenue, Suite 261, Phoenix, AZ 85007
Telephone 602-771-2810 Fax: 602-381-1225 www.azdfi.gov
1. Applicant Name - Owner/Officer/Legal Counsel:
2. Applicant’s Email address:
3. What is the organization’s exact name requested for approval?
4. What is the nature of the business or activities that will be conducted by the organization using this
name (in detail): Attach separate sheet if needed.
5. State why the prohibited word is being used and why use of the word does not violate Arizona Revised
6. List any other pertinent information that will assist in determining whether approval is in order:
7. Is a copy of your Corporation Commission filing attached?