COMMONWEALTH OF VIRGINIA STATE CORPORATION COMMISSION BTA1215 (07/06) APPLICATION FOR RESERVATION OR FOR RENEWAL OF RESERVATION OF A BUSINESS TRUST NAME The undersigned applies, pursuant to the provisions of § 13.1-1215 of the Code of Virginia, for (MARK APPROPRIATE BOX): reservation of the following business trust name for a period of 120 days renewal of the reservation of the following business trust name for an additional period of 120 days BUSINESS TRUST NAME BEING RESERVED OR RENEWED: _____________________________ __________________________________________________________________________________ (see instructions for requirements) Printed name of applicant: __________________________________________________________ (see instructions regarding “applicant”) Printed address: __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ It is a Class 1 misdemeanor for any person to sign a document he or she knows is false in any material respect with intent that the document be delivered to the Commission for filing. See § 13.1-1205 of the Code of Virginia. Signature of applicant or applicant’s authorized agent: __________________________________________________________ If the applicant is an entity or the application is signed by an authorized agent of the applicant, the following must be completed: ______________________________ (printed name of authorized agent) Phone number of applicant or applicant’s authorized agent (optional): ______________________ (title) ( ________) __________ – ________________ FOR SCC USE: DCN ________________________ EXP. __________________ R ____________________ INSTRUCTIONS ON REVERSE American LegalNet, Inc. www.USCourtForms.com INSTRUCTIONS The application must be in the English language, typewritten or printed in black, legible and reproducible. The document must be presented on uniformly white, opaque paper, free of visible watermarks and background logos. You can download this form from our website at www.scc.virginia.gov/division/clk/fee_bus.htm. The proposed name must be distinguishable upon the records of the Commission. See § 13.1-1214 of the Code of Virginia. To check the availability of a business trust name, please contact the Clerk’s Office Call Center at (804) 371-9733 or toll-free in Virginia at (866) 722-2551. The business trust name may not include the phrase “trust company.” Furthermore, the business trust name may not contain the words or phrases “corporation,” “professional corporation,” “incorporated,” “limited company,” “limited liability company,” “professional limited liability company,” “limited partnership,” “registered limited liability partnership,” “limited liability partnership,” “registered limited liability limited partnership,” or “limited liability limited partnership;” the abbreviations “Corp.,” “Inc.,” “L.C.,” “LC,” “L.L.C.,” “LLC,” “P.C.,” “PC,” “P.L.C.,” “PLC,” “P.L.L.C.,” “PLLC,” “L.P.,” “LP,” “R.L.L.P.,” “RLLP,” “L.L.P.,” “LLP,” “R.L.L.L.P.,” “RLLLP,” “L.L.L.P.,” or “LLLP;” or any word or phrase the use of which is prohibited by law for the business trust. See § 13.1-1214 of the Code of Virginia. The “applicant” is the individual or entity that is the sole holder of the reserved name. A reserved name may be renewed only by or on behalf of the applicant who holds the reserved name. The owner of a reserved business trust name may renew the reservation for successive periods of 120 days each by filing with the Commission, during the 45-day period preceding the date of expiration of the reservation, a renewal application. See § 13.1-1215 of the Code of Virginia. Submit the original, signed application to the Clerk of the State Corporation Commission, P.O. Box 1197, Richmond, VA 23218-1197 (Street address: 1300 E. Main Street, Tyler Building, 1st Floor, Richmond, VA 23219), along with check for the filing fee in the amount of $10.00, payable to the State Corporation Commission. If you have any questions, please call (804) 371-9733 or toll-free in Virginia, (866) 722-2551. NOTE A transfer of a reserved name may be accomplished by submitting to the Clerk’s Office a written notice that sets forth the reserved name and the name and address of the person to whom the name is to be transferred, accompanied by a check in the amount of $10.00 made payable to the State Corporation Commission. The notice must be signed by the applicant that holds the reserved name or by the applicant’s authorized agent. American LegalNet, Inc. www.USCourtForms.com