Under 247303 of the Not-for-Profit Corporation Law PLEASE TYPE OR PRINT NAME AND ADDRESS NAME TO BE RESERVED RESERVATION IS INTENDED FOR (CHECK ONE) New domestic corporation (247301 of the Not - for - Profit Corporation Law requires that the name contain or or one of the other words or abbreviations indicative of corporate character unless it meets one of the exceptions in 247301.) F oreign corporation intending to apply for authority to conduct activities in New York State* Proposed foreign corporation, not yet incorporated, intending to apply for authority to conduct activities in N ew York State Change of name of an existing domestic or an authorized foreign corporation* Fictitious name for a f oreign corporation intending to apply for authority to conduct activities in New York State whose real corporate name is not available for use in New York State* Fictitious name for an a uthorized foreign corporation intending to change its fictitious name under which it conducts activities in this state* Fictitious name for an a uthorized foreign corporation which has changed its corporate name in its jurisdiction, such new real corporate name not being available for use in New York State* X Signature of applicant, attorney or agent Typed/printed name of signer (If attorney or agent, so specify) NOTES: 1. Upon filing this application, the name will be reserved for 60 days and a certificate of reservation will be issued. 2. The certificate of reservation must be returned with and attached to the certificate of incorporation or application for authority, amendment or with a cancellation of the reservation. 3. The name used must be the same as appears in the reservation. 4. A $10 fee payable to the Department of State must accompany this application. *If the reservation is for an existing corporation, domestic or foreign, the corporation must be the applicant. DOS-0635-f-a (Rev. 07/16) Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com