F0016 - Page 1 of 1 OFFICE OF THE MISSISSIPPI SECRETARY OF STATE P.O. BOX 136, JACKSON, MS 39205-0136 (601) 359-1333 Reservation of Name *0016-1-1* 1. Type of Corporation (X in one only) Mississippi Profit Mississippi Nonprofit Mississippi Limited Partnership Foreign Limited Partnership Foreign Profit Foreign Nonprofit 2. Name to reserve 3. (For Foreign Corporations and Limited Partnerships ONLY) - Name elected to use in Mississippi 4. Applicants name and address Address City, State, ZIP5, ZIP4 - Signature (Please keep writing within blocks) of Owner/ Applicant Rev. 01/96