STATE OF SOUTH CAROLINA SECRETARY OF STATE APPLICATION TO RESERVE A LIMITED LIABILITY COMPANY NAME TYPE OR PRINT CLEARLY IN BLACK INK The applicant applies to reserve the exclusive use of a Limited Liability Company name (including in accordance with Section 33-44-1005 of the 1976 South Carolina Code of Laws, as amended a fictitious name for a foreign Limited Liability Company whose name is not available), for a non-renewable one hundred and twenty (120) day period as provided in Section 33-44-106 of the 1976 South Carolina Code of Laws, as amended. 1. The Limited Liability Company name to be reserved which complies with the requirements of Section 33-44-105 or Section 33-43-1005 of the 1976 South Carolina Code of Laws, as amended, is The name and address of the applicant is Name ___________________________________________________________________________________________ Street Address ___________________________________________________________________________________________ City State Zip Code 2. Date ______________________ ______________________________________ Signature of Applicant FILING INSTRUCTIONS 1. 2. File two copies of this application, the original and either a duplicate original or a conformed copy. This application must be accompanied by the filing fee of $25.00, payable to the Secretary of State. Return to: Secretary of State 1205 Pendleton Street Suite 525 Columbia SC 29201 NOTE RESERVING THIS CORPORATE NAME DOES NOT, IN AND OF ITSELF, PROVIDE AN EXCLUSIVE RIGHT TO USE THIS CORPORATE NAME ON OR IN CONNECTION WITH ANY PRODUCT OR SERVICE. USE OF A NAME AS A TRADEMARK OR SERVICE MARK WILL REQUIRE FURTHER CLEARANCE AND REGISTRATION AND BE AFFECTED BY PRIOR USE OF THE MARK. FOR MORE INFORMATION, CONTACT THE TRADEMARKS DIVISION OF THE SECRETARY OF STATE'S OFFICE. . Form Revised by South Carolina Secretary of State, March 2011 American LegalNet, Inc. www.FormsWorkFlow.com