COMMONWEALTH OF VIRGINIA STATE CORPORATION COMMISSION SCC631/830 APPLICATION FOR RESERVATION OR FOR (08/05) RENEWAL OF RESERVATION OF CORPORATE NAME The undersigned applies, pursuant to the provisions of 13.1-63 1 or 13.1-830 of the Code of Virginia, for (MARK APPROPRIATE BOX): reservation of the following corporate name for a period of 120 days renewal of the reservation of the following corporate name for an additional period of 120 days CORPORATE NAME BEING RESERVED OR RENEWED: __________________________ ________________________________________________________________________ ___ (see instructions for requirements) THE RESERVED NAME IS FOR A (MARK APPROPRIATE BOX): STOCK CORPORATION NONSTOCK CORPORATION 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 kno ws is false in any material respect with intent that the document be delivered to the Commission for filing. Signature of applicant or applicants 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) (title) (Optional) Phone number of applicant or applicants authorized agent:: ( ________) __________ ________________ FOR SCC USE: DCN __________________________ EXP. _____________ R _________________ INSTRUCTIONS ON REVERSE American LegalNet, Inc. www.USCourtForms.com>>>> 2 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 Commis sion. See 13.1- 630 of the Code of Virginia for a stock corporation and 13.1-829 of the Code for a nonstock corporation. To check the availability of a corporate name, please contact the Clerks Office Call Center at (804) 371-9733 or toll-free in Virginia at (866) 722- 2551. If the name reservation is for a stock corporation (pursuant to 13.1-631 of the Code of Virginia), then the name shall include the word: "Corporation," "Incorporated," "Company" or "Limited," OR the abbreviation "Corp.," "Inc.," "Co." or "Ltd."; provided, however, that the name of a professional stock corporation may include, in lieu of the foregoing, th e words professional corporation or a professional corporation or the abbreviation P.C. or PC at the end of the corporate name. See 13.1-544.1 and 13.1-630 of the Code of Vir ginia. 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 name for a stock corporation 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 13.1-631 of the Code of Virginia. A renewal application for a nonstock corporation should be submitted to the Clerk of the State Corporation Commission during the 45-day period preceding expiration of the name reservation. Important: If the applicant does not indicate whether the name reservation or renew al is for a stock corporation or a nonstock corporation, the application will be pro cessed on the assumption that it is being submitted for a stock corporation. Submit the original, signed application to the Clerk of the State Corpor ation Commission, P.O. Box 1197, Richmond, Virginia 23218-1197, (Street address: 1300 East Main Street, Tyler st Building, 1 Floor, Richmond, Virginia 23219), along with a check for the filing fee in the amount of $10.00, payable to the State Corporation Commission. PLEASE DO NOT SEND CASH . If you have any questions, please call (804) 371-9733 or toll-free in Vir ginia, 1-866-722-2551. NOTE A transfer of a reserved name may be accomplished by submitting to the Clerks Office a written notice that sets forth the reserved name and the name and addres s 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 for whom the name was reserved or by the applicants authorized agent. American LegalNet, Inc. www.USCourtForms.com