FILING FEE: $30.00 Revised 201 Neb. Rev. Stat. 24421-231 & 24421-1932! APPLICATION FOR RESERVATION OF CORPORATE NAME , Secretary of State P.O. Box 94608 Lincoln, NE 68509 The undersigned hereby requests that the following name be reserved. Name to be Reserved Reservation is good for 120 days and is not renewable. DATED Signature Printed Name/Title Street Address City, State, Zip NOTE: Every filing must be signed by the chairperson of the board of directors, the president, or one of the officers of the corporation. If the corporation has not yet been formed or directors have not yet been selected, the filing shall be signed by an incorporator. If the corporation is in the hands of a receiver, trustee, or other court appointed fiduciary, the filing shall be signed by that fiduciary. American LegalNet, Inc. www.FormsWorkFlow.com