Application For Reservation Of Name For Domestic Or Foreign Form - Secretary Of State - Connecticut
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1APPLICATION
FOR RESERVATION
OF NAME
FOR DOMESTIC OR FOREIGN
STOCK & NON-STOCK
CORP, LLC, LP, LLP & STATUTORY
TRUST
Office of the Secretary of the State
30 Trinity Street / P.O. Box 150470 / Hartford, CT 06115-0470 / Rev. 12/l 999
Space For Office Use Only
The undersigned hereby applies for reservation of the following name:
1. NAME:
(See instructions
for appropriate
business/entity designation on the reverse side of this form)
.
NAME OF APPLICANT:
3 . ADDRESS OF APPLICANT:
(Complete address required.
Street name, city, state & zip code.)
4. EXECUTION:
SIGNATURE
OF APPLICANT
(and title if applicable)
The reservation will be effective for a period of 120 days following filing.
Please tvpe or print all information
other than the
signature.
See reverse for instruction
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