o
Filing fee The ling fee for this form is $35.
o
Payment Please enclose a check or money order payable to the Secretary of State. Forms received
without the appropriate fee will not be accepted for ling. Please do not send cash. NOTICE:
There is a $25 service fee for all checks returned by your nancial institution. Also, to
expedite processing, please do not use staples on your documents or to attach checks.
o
Reservation The name reservation is effective for 120 days. This is not a name registration. It is a method
to temporarily reserve an entity name until your are ready to le a formation document for the
entity.
o
Renewal Name reservations may not be renewed. If a reservation is submitted prior to the expiration of a
current name reservation, the new reservation will be rejected.
o
Transfer right The original applicant may transfer the right to a reserved name by ling a written notice
of such transfer. The notice should include the name and address of the transferee (new
applicant).
kansas secretary of state
Temporary Reservation of
Business Entity Name
Instructions
Kansas Ofce of the Secretary of State:
Memorial Hall, 1st Floor (785) 296-4564
120 S.W. 10th Avenue kssos@sos.ks.gov
Topeka, KS 66612-1594 www.sos.ks.gov
NR
52-01
The following form must be complete and
accompanied by the correct filing fee or the
document will not be accepted for filing.
Inst.
K.S.A. 17-7402
Rev. 6/2/15 tc
Please proceed to form.
Save time and money by filing your forms
online at www.sos.ks.gov. There, you can
also stay up-to-date on your organization’s
status, annual report due date, and contact
addresses.
This form must be complete and accompanied by the correct ling fee or the document will not be accepted for ling.
1. The undersigned
reserves the following
entity name
Entity name to be reserved
2. Name of applicant
3. Address of the
applicant
Address
City State Zip Code Country
Signature of Applicant
X
Month Day Year
Name of Signer (Printed or Typed) Title Phone Number
1 / 1
K.S.A. 17-7402
Rev. 6/2/15 tc
kansas secretary of state
Temporary Reservation of
Business Entity Name
Kansas Ofce of the Secretary of State:
Memorial Hall, 1st Floor (785) 296-4564
120 S.W. 10th Avenue kssos@sos.ks.gov
Topeka, KS 66612-1594 www.sos.ks.gov
NR
52-01
THIS SPACE FOR OFFICE USE ONLY.
Please review to ensure completion.
Print
Reset
Please complete the form, print, sign and mail to the
Kansas Secretary of State with the filing fee. Selecting
'Print' will print the form and 'Reset' will clear the entire
form.