STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS Office of the Secretary of State Corporations Division 100 North Main Street Providence, Rhode Island 02903-1335 APPLICATION FOR RESERVATION OF ENTITY NAME The undersigned applicant hereby applies for reservation of the following entity name for a period of one hundred twenty (120) days from the date of this filing. (Name to be Reserved) The name is being reserved for the following type of entity pursuant to the applicable statutory provision: (Check One Only) Filing Fee Business Corporation (including professional and foreign corporations) pursuant to Section 7-1.1-8 of the General Laws of Rhode Island, 1956, as amended. ($50.00) Limited Partnership (including foreign limited partnerships) pursuant to Section 7-13-3 of the General Laws of Rhode Island, 1956, as amended. ($50.00) Limited Liability Company (including foreign limited liability companies) pursuant to Section 7-16-10 of the General Laws of Rhode Island, 1956, as amended. ($50.00) Non-Profit Corporation (including foreign non-profit corporations) pursuant to Section 7-6-11.1 of the General Laws of Rhode Island, 1956, as amended. ($20.00)The name reservation will be recorded exclusively in the name of the applicant. The right to the exclusive use of a specified entity name so reserved may be transferred to any other person or entity by filing a notice of the transfer, executed by the applicant for whom the name was reserved, specifying the name and address of the transferee, and paying the appropriate fee. Name and Address of Applicant: Under penalty of perjury, I declare and affirm that the information contained herein is true and correct. Submitted by: Date: (Signature) (Address, if different from above) Form No. 620 Revised: 01/99 >>>> 2 INSTRUCTIONS FOR FILING APPLICATION FOR RESERVATION OF ENTITY NAME Section 7-1.1-8, 7-13-3, 7-16-10 and 7-6-11.1 of the General Laws of Rhode Island, 1956, as amended1. The proposed name of a business corporation, limited partnership, limited liability company or non-profit corporation may be reserved for a period of one hundred and twenty (120) days. Only persons intending to organize a Rhode Island business corporation, limited partnership, limited liability company or non-profit corporation, persons intending to qualify a foreign (out-of-state) business corporation, foreign limited partnership, foreign limited liability company or non- profit corporation to transact business in Rhode Island, or any such entity which intends to change its name may reserve a name using this reservation form. The name reservation application should set forth the entity name to be reserved, the type of entity, the name and address of the person for whom the reservation is made, and must be signed and dated by the applicant or the attorney or agent thereof. 2. In compliance with various statutes under Rhode Island General Laws, 1956, as amended, a proposed name cannot be the same as, or deceptively similar to, the name of any entity or any name reservation or registration filed with the Office of the Secretary of State, Corporations Division. Name availability may be checked prior to submitting this form by calling (401) 222-3040. This is, however, only a preliminary clearance. The final decision regarding name availability will be made when the application is submitted for filing. 3. With the sole exception of a name reservation for a limited partnership , there is no provision for renewal of a name reservation. Consequently, a subsequent application for reservation of the same corporate or limited liability company name will not be accepted for filing until the original reservation has expired. 4. Once having reserved the name of a limited partnership , the same applicant may not again reserve the same name until more than sixty (60) days after the expiration of the last one hundred and twenty (120) day period for which that applicant reserved that name. PLEASE NOTE that the filing fee for renewing a limited partnership name is $75.00. 5. Payment of the correct filing fee for reserving an entity name should be made payable to the Rhode Island Secretary of State. If you have any questions, please call us at (401) 222-3040, Monday through Friday, between 8:30 a.m. and 4:30 p.m.Form No. 620 Revised: 01/99