____________________________________________________________________
STATE OF DELAWARE
CORPORATE NAME RESERVATION
APPLICATION PURSUANT TO
TITLE 8, SECTION 102
OF THE DELAWARE CODE
TO: THE SECRETARY OF STATE
OF THE STATE OF DELAWARE
PLEASE RESERVE, IF AVAILABLE, THE FOLLOWING CORPORATE NAME:
(list nam
e to be reserved here)
FOR THE EXCLUSIVE PERIOD OF 120 DAYS PURSUANT TO THE PROVISIONS OF
TITLE 8, SECTION 102 OF THE DELAWARE CODE, THE UNDERSIGNED BEING THE
PERSON INTENDING TO FORM A CORPORATION AND ADOPT THE ABOVE
RESERVED NAME, HEREBY EXECUTES THIS APPLICATION THIS
DAY OF _______________________, ________A.D. _____________________
NAME AND ADDRESS OF APPLICANT: (if reserving for
a company or firm, please list the
firm or company name and have an attention person added to the bottom after the address)
BY:_________________________________
Signature of Applicant
Name:_________
________________________
Print or Type Name