APPLICATION FOR FICTITIOUS NAME
Select entity type:
For-Profit Corporation ($25.00 fee)
General Partnership ($15.00 fee)
LLC ($25.00 fee)
LLLP ($15.00 fee)
Pursuant to the provisions of Arkansas law, the undersigned entity hereby applies for the use of a fictitious
name and submits herewith the following statement:
1. The fictitious name under which the business is being, or will be, conducted by this entity is:
________________________________________________________________________________
2. The character of the business being, or to be, conducted under such fictitious name is:
________________________________________________________________________________
3. a) The entity name of the applicant and its date of qualification in Arkansas: Date: _______________
Name: ___________________________________________________________________________
b) The entity is Domestic
Foreign (state of domestic registration) ________________
c)
The location (city and street address) of the registered office of the applicant entity in Arkansas is:
_________________________ _________________________ __________ ______________
Street City State ZIP Code
I understand that knowingly signing a false document with the intent to file with the Arkansas
Secretary of State is a Class C misdemeanor and is punishable by a fine up to $100.00 and/or impris-
onment up to 30 days.
Authorizing Officer _________________________________________________________________
(Type or Print)
Authorized Signature: ______________________________________________________________
(Chairman, Partner or other authorized person)
Address: _________________________________________________________________________
DN-18/F-18 Rev. 9/20
INSTRUCTIONS:
File with the Secretary of State's Office, Business Services Division, State Capitol, Little Rock,
Arkansas 72201-1094. A copy will be returned to the entity and must be filed with the County Clerk in the coun-
ty in which the entity’s registered office is located (unless registered office is in Pulaski County).
Arkansas Secretary of State
1401 W. Capitol, Suite 250,
501-682-3409 • www.sos.arkansas.gov
Little Rock, AR 72201
Nonprofit Corporation ($25.00 fee)
Limited Partnership ($15.00 fee)
LLP (
$15.00 fee)
Series LLC ($25.00 fee)
John Thurston
