UNRR-4 Rev. 5/03 New Jersey Division of Revenue Application for Registration of a Foreign Business Name Pursuant to the laws of the State of New Jersey, the undersigned applicant hereby applies for the registration of a business name for (check one): __ For-Profit Corporation (Title 14A) __ Non-Profit Corporation (Title 15A) __ Limited Partnership (Title 42:2A) The business name to be registered is: State of Incorporation/Formation: Main Business Address of Applicant: Street: City: State: Zip: The undersigned attests that the above is currently engaged in and conducting business, and is in good standing. (Corporations must attach a certificate of good standing dated not more than 30 days prior to filing with the New Jersey State Treasurer.) The undersigned also attests that they are authorized to sign on behalf of the above-named business. Applicant's Signature: Applicant's Name (type): Date: This registration will be effective for the balance of the calendar year of the effective (filing) date and for the next calendar year. The registration may be renewed in subsequent calendar years, between the first day of October and the thirty-first day of December. NJ Division of Revenue, PO Box 308, Trenton, NJ 08646 American LegalNet, Inc. www.FormsWorkflow.com Rev 2/15/06 Instructions for Form UNRR-4 APPLICATION FOR REGISTRATION OF A FOREIGN BUSINESS NAME This document registers the use of a business name in New Jersey. Since there are no provisions for a foreign LLC to register a business name, a LLC may opt to reserve a business name either online or by using Form UNRR-1. If you wish to obtain authority to do business in this State, you must also file form "Public Records Filing for New Business Entity". This document is in addition to tax and employer registration. STATUTORY FEE: See Below The MANDATORY fields are: Business Type Choose the business type/statutory authority under which you are filing: $50 For-Profit Corporation (Title 14A) $50 Non-Profit Corporation (Title 15A) $50 Limited Partnership (Title 42:2A) Name List the business name to registered. **The name must be distinguishable from other names on the State's database. The Division of Revenue will check the proposed name for availability as part of the filing review process. State of Incorporation/Formation List the state or jurisdiction in which the business incorporated, formed, etc. Main Business Address of Applicant List the main business address. ATTESTATIONS Provide statements that indicate: 1) the business is currently engaged in and conducting business; 2) the business is in good standing; and 3) the signers are authorized to sign on behalf of the business. Form UNRR-4 provides these statements. ATTACHMENTS Corporations must attach a certificate of good standing dated not more than 30 days prior to filing with the Secretary of State. EXECUTION (Signature/Date) Have the appropriate party sign and date the application: Corporations -- chairman, president or vice-president Limited Partnerships -- a general partner ********** These documents should be filed in duplicate. Non-profits should file in triplicate. Make checks payable to: TREASURER, STATE OF NEW JERSEY. (No cash, please) Mail to: NJ Division of Revenue, PO Box 308, Trenton, NJ 08646 FAX File: 609.984.6851 (Fax Filing is an optional expedited service subject to processing fees that are in addition to those stated above. For FAX Filing information, visit http://www.state.nj.us/treasury/revenue/dcr/programs/ffs.html. ) American LegalNet, Inc. www.FormsWorkflow.com