Arizona Corporation Commission APPLICATION FOR RESERVATION OF A CORPORATE NAME THIS RESERVATION IS FOR A PERIOD OF 120 DAYS PURSUANT TO THE PROVISIONS OF A.R.S. §10402, §10-3402, & §29.603. THIS APPLICATION MUST BE ACCOMPANIED BY THE APPLICATION FEE OF $10.00 (FOR REGULAR SERVICE) OR $45.00 ($10.00 APPLICATION FEE PLUS $35.00 EXPEDITE FEE) – (A.R.S. §10-122 and §29-851) MADE PAYABLE TO THE ARIZONA CORORATION COMMISSION. NAME TO BE RESERVED: (Include any corporate identifiers. For a list of identifiers, refer to the Naming Standards on the Commision's web site) __________________________________________________________________________ _____________________________________________________ Name of Applicant executing the reservation (Note: this name MUST be listed in the subsequent filing of articles) By affixing the name above, the applicant is hereby executing the name reservation. _____________________________________________________ Address _____________________________________________________ City, State, Zip Indicate Initial Entity Type: (choose one only) BUSINESS CORPORATION LIMITED LIABILITY COMPANY NON-PROFIT CORPORATION PROFESSIONAL CORPORATION PROFESSIONAL L.L.C. CLOSE CORPORATION CO-OPERATIVE NAME REGISTRATION NON-FILING INSURANCE LOAN CORPORATE SOLE CREDIT UNION TRUST Fee included: (check one) $10.00 Name Reservation (Regular Service) $45.00 Expedite service ($10.00 Name Reservation + $35.00 expedited service) ________________________________________________________________ Party Filing the Application Upon receipt the filer will receive a written confirmation indicating the approval or denial of the reservation. This documentation will be delivered via (Check one below): Fax: (___) ____________ Pickup by Filer: (___) ______________ Mail to: _____________________________________ FOR ACC USE ONLY _____________________________________ (Address if different than applicant) Submit Application to: Arizona Corporation Commission Corporate Filings Section 1300 W Washington Phoenix AZ 85007 FAX: 602-542-4100 Doc Id Doc Type File Number Date Recvd Status _____________ _____________ _____________ _____________ _____________ CF0059 Rev. 11/2005 American LegalNet, Inc. www.USCourtForms.com