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Application For Reservation Of Business Name

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Business Registration - Optional Inclusion of Ownership Data

State of Utah

Print Form

DEPARTMENT OF COMMERCE

Division of Corporations & Commercial Code

Clear Form

Application for Reservation of Business Name

Check Here If: Non-Refundable Processing Fee: [ ] New Filing $22.00 [ ] Renewal $22.00 File Number:

The reservation is for 120 days, effective from date of approval. The reservation expires at 5:00 p.m. on the 120th day.

The Business Name to be Reserved:

Please describe the intended business use of the reserved name:

This application is not for permission to use a business name. It is merely for a reservation of a name. The

reservation of a business name does not create an ownership right in the name, nor may the name be used until the

business entity is fully registered, authorized or incorporated under the laws of this State. In order to register a

business entity under the reserved name prior to the 120 day expiration of the name reservation, the name

reservation will need to be canceled. I do hereby certify that I have read the foregoing provisions and agree to

comply therewith in making and submitting this application,

Applicant Information:

Applicant:

Name: _______________________________________________________________________________

List the individual or business

Entity Number (if a registered business): ____________________________________________________

entity that will own the Name

Reservation on the name line.

Address: _____________________________________________________________________________

City: ____________________________________________________ State: ________ Zip: ____________

Under penalties of perjury, I declare that this Name Reservation has been examined by me and is, to the best

of my knowledge and belief, true, correct and complete.

Applicant must sign here after the form is printed

Signature:

Under GRAMA {63-2-201}, all registration information maintained by the Division is classified as public record. For confidentiality purposes, you may use the

business entity physical address rather than the residential or private address of any individual affiliated with the entity.

Division's Website:

Mailing/Faxing Information: