Check Here if: Non-Refundable Processing Fee: [ ] New Filing $22.00 [ ] Renewal $22.00 File Number:
This application does not register or renew a business filing
When approved, your Registered Name is effective until December 31st of current year. Pursuant to
provisions of Utah law (U.C.A. Section 16-10a-1507), the undersigned corporation hereby applies to
register its corporate name through and including December 31, 20____, and states as follows:
The name of the corporation is:
It is incorporated under the laws of the state of:
The date of its incorporation is:
The business in which it is engaged is:
This application is accompanied by a certificate setting forth that this corporation is in existence under the laws of
the state of _____________________________ wherein it is incorporated, which is executed by the state agency
having custody of the records pertaining to corporations in that state. The certificate of existence must not be
older than 90 days.
Applicant Information:
Applicant/Owner:
Name: ___________________________________________________________________________
Entity Number (if a registered business): ________________________________________________
Address: _________________________________________________________________________
City: ______________________________________________ State: ________ Zip: ____________
Under penalties of perjury, I declare that this Application for Registration of Corporate Name
has been examined by me and is, to the best of my knowledge and belief, true, correct and
complete.
Signature:
Under
GRAMA {63G-2-201}, all registration information maintained by the Division is classified as public record. For confidentiality purposes,
you may use the business entity physical address rather than the residential or private address of any individual affiliated with the entity.
State of Utah
DEPARTMENT OF COMMERCE
Division of Corporations & Commercial Code
Application for Registration of Corporate Name
This form cannot be hand written.
Applicant must sign here after the form is printed
Mailing/Faxing Information:
www.corporations.utah.gov/contactus.html
www.corporations.utah.gov
