ROSS MILLER Secretary of State 204 North Carson Street, Suite 4 Carson City, Nevada 89701-4520 (775) 684 5708 Website: www.nvsos.gov Name Reservation Request USE BLACK INK ONLY - DO NOT HIGHLIGHT ABOVE SPACE IS FOR OFFICE USE ONLY I, , hereby request that the name be reserved for the period of 90 days. Holder of Reservation: Name Address City State Zip (choose only one) Confirmation of Reservation: Mail to holder of reservation at the above address. Email to the following address: See other instructions below: Notes: FILING FEE: $25.00 This form must be accompanied by appropriate fee. Nevada Secretary of State Name Reservation Revised: 4-10-09 American LegalNet, Inc. www.FormsWorkFlow.com