Secretary of State Office
500 E Capitol Ave
Pierre, SD 57501
(605)773-4845
corpinfo@state.sd.us
Purs
uant to the provisions of the South Dakota Law, the undersigned hereby applies for reservation of the following
name for a period of one hundred twenty (120) days. The same applicant may not again reserve the same name until
more than sixty days after the expiration date.
1. Name of Applicant:
2. The address of the principal office:
Actual Street Address City State ZIP+4
Mailing Address in this State, if Different from Street Address City State ZIP+4
3. The name to be reserved is:
4. Check one to indicate how the reserved name is to be used:
Incor
poration of a domestic nonprofit corporation
Domestic nonprofit corporation intending to change its name
Foreign nonprofit corporation intending to make application for Certificate of Authority
Forei
gn nonprofit corporation authorized in this state intending to change its name
Any person intending to organize a foreign nonprofit corporation and to have such corporation make an
application for a Certificate of Authority
No pers
on may execute this report knowing it is false in any material respect. Any violation may be subject to a criminal
penalty (SDCL 22-39-36).
Dated
Signature of an authorized person
Email
(Optional) Printed Name
Title
Address
City
APPLICATION FOR
RESERVATION OF NAME
NONPROFIT CORPORATION
SDCL 47-22-9, 10
FILING FEE: $25
Make check payable to SECRETARY OF STATE
State Zip
nonprofitnamereservation Feb 2018
click to sign
signature
click to edit
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