Print Form STATE OF SOUTH CAROLINA SECRETARY OF STATE APPLICATION TO RESERVE A NAME Nonprofit Corporation – Domestic and Foreign Filing Fee - $10.00 TYPE OR PRINT CLEARLY WITH BLACK INK 1. Pursuant to S.C. Code of Laws §33-31-402, the undersigned hereby applies to the Secretary of State to reserve the following corporate name: _______________________________________________________________________________________ for a nonrenewable period of one hundred twenty days from the date of filing this application. 2. Name, address and signature of the applicant: ________________________________________________________________________________________ Name ________________________________________________________________________________________ Street Address ________________________________________________________________________________________ City State Date______________________ Zip Code ____________________________________________ Signature of Applicant ____________________________________________ Type or Print Name Filing Checklist ■ ■ ■ ■ Application to Reserve a Name (filed in duplicate) $10.00 made payable to the South Carolina Secretary of State Self-Addressed, Stamped Return Envelope Return all documents to: South Carolina Secretary of State’s Office Attn: Corporate Filings P.O. Box 11350 Columbia, SC 29211 NOTE Registering your 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 Approved by South Carolina Secretary of State, December 2009 American LegalNet, Inc. www.FormsWorkFlow.com