State of New Hampshire Filing fee: $50.00 Use black print or type. Form TN-1 RSA 349 APPLICATION FOR REGISTRATION OF TRADE NAME (PLEASE TYPE OR PRINT CLEARLY) 1. BUSINESS NAME: (Name cannot include "INC." or other corporate designation) 2. BUSINESS ADDRESS: No. & Street City / town City / town State State Zip Zip MAILING ADDRESS (if different): No. & Street 3. BRIEF DESCRIPTION OF KIND OF BUSINESS TO BE CARRIED ON: 4. DATE BUSINESS ORGANIZED: (month / day / year) 5-A. ENTITY APPLICANT: IF THE APPLICANT IS A CORPORATION OR OTHER ENTITY, LIST CORPORATION'S OR ENTITY'S EXACT NAME AND INCLUDE TITLE OF PERSON SIGNING. If more space is needed for additional entity applicants, please attach additional sheet(s). ENTITY NAME (TYPE OR PRINT) NO. STREET AUTHORIZED SIGNATURE TOWN/CITY STATE ZIP SIGNER'S NAME AND TITLE (TYPE OR PRINT) 5-B. INDIVIDUAL APPLICANTS: PLEASE TYPE OR PRINT APPLICANTS' NAME(S), ADDRESS(ES) AND INCLUDE SIGNATURE. If more space is needed for additional individual applicants, please attach additional sheet(s). 1. TYPE OR PRINT NAME NO. STREET SIGNATURE TOWN/CITY STATE ZIP 2. TYPE OR PRINT NAME NO. STREET SIGNATURE TOWN/CITY STATE ZIP 3. TYPE OR PRINT NAME NO. STREET SIGNATURE TOWN/CITY STATE ZIP DISCLAIMER: All documents filed with the Corporation Division become public records and will be available for public inspection in either tangible or electronic form. Mail fee and DATED AND SIGNED ORIGINAL to: Corporation Division, Department of State, 107 North Main Street, Concord, NH 03301-4989. Physical location: 25 Capitol Street, Concord, NH 03301. Form TN-1 Pg 1 (05/2012) American LegalNet, Inc. www.FormsWorkFlow.com About Trade Name Registration New Hampshire law requires that anyone doing business under any name other than his or her own must register that name with the Secretary of State. The fee for registration is $50.00. The purpose of registration is to let the public know who is transacting business under a particular business name. The Secretary of State will not register a name that might be confused with one already registered. Filling out the trade name application requires the following: 1. Exact trade name being registered (your name will be checked for availability when the application is filed). You may call the Secretary of State's Information Line (603-271-3246) to have the business name checked for availability. However, even if you have checked your name with the Secretary of State's Information Line, you should not consider it finally approved or proceed with printing, advertising, etc. using that name until your application is processed and you receive your trade name certificate. A telephone name check is preliminary only. 2. Complete address of the business. If the mailing address for the business is different from the listed business address, please insert the complete mailing address on the line provided. 3. Brief description of type of business (e.g. real estate, hairdresser, etc.). 4. Date business was organized. 5-A & B. Applicants: may be an individual, corporation, limited liability company, limited liability partnership, group of partners or association. Original signatures of all applicants; if a corporation, of an authorized officer; if a limited liability company, by the manager or if no manager, by a member; if a limited liability partnership, by one or more authorized partners. Form TN-1 Pg 2 (05/2012) American LegalNet, Inc. www.FormsWorkFlow.com