Form Nr-1 - Application For Name Reservation - 2014
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1
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3Natalie E. Tennant
Penney Barker, Manager
Secretary of State
Corporations Division
1900 Kanawha Blvd E.
Tel: (304)558-8000
Bldg. 1, Suite 157-K
Fax: (304)558-8381
Charleston, WV 25305
Website:
E-mail:
APPLICATION FOR
FILE ONE ORIGINAL
Office Hours: Monday – Friday
(Two if you want a filed
NAME RESERVATION
Hrs: 8:30 a.m. – 5:00 p.m. ET
stamped copy returned to you)
FEE: $15.00
1. I want to reserve the following name for a
period of one hundred twenty (120) days:
___________________________________________________
2. The name will be used for a (check one):
Corporation
Limited Liability Company
Limited Partnership
Business Trust
Voluntary Association
Limited Liability Partnership
Organize as a West Virginia company.
3. The person or company reserving this
name intends to (check one):
Change existing (present) company name.
Qualify as a foreign company in West Virginia – the
original state of registration is
4. The name and address of the
Name:
_______________________________________
applicant (person or company) is:
Street:
Street Address: _______________________________________
City/State/Zip: _______________________________________
5. Signature information (see *Important Legal Notice Regarding Signature in the attached instructions):
Signature: ____________________________________ Date: ______________________________
Title: ______________________________
Important Note: This form is a public document. Please DO NOT provide any personal identifiable information on this form
such as social security numbers, bank account numbers, credit card numbers, tax identification or driver’s license numbers.
ACKNOWLEDGEMENT
(For office use only)
TO THE APPLICANT:
The name is reserved for the exclusive use of the applicant for one hundred twenty (120) days
beginning ______________________ and ending ___________________________.
The name is NOT available (see attached name conflict), and the application is accordingly denied.
NATALIE E. TENNANT
Secretary of State
BY:_____________________________________
Business & Licensing Clerk
Form NR-1
Issued by the Office of the Secretary of State
Revised 11/14
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