Pennsylvania Department Of State Bureau Of Corporations And Charitable Organizations - Transfer Of Reservation Page 3

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DSCB:15-208–Instructions
4. Give the name of the person or association to whom the
reservation is transferred. This field is required for Transfer
of Name Reservation only.
5. Give the address of the person or association to whom the
reservation is transferred. This field is required for Transfer
of Name Reservation only.
Signature and Verification
The person or an authorized representative of the association
reserving the name must sign the Name Reservation. A
Transfer of a Name Reservation must be signed by the
transferor (the individual or association that initially reserved
the name). A Transfer of a Name Reservation may not be
signed by the transferee (the person to whom the name is
transferred).
Signing a document delivered to the Department for filing is
an affirmation under the penalties provided in 18 Pa.C.S.
§ 4904 (relating to unsworn falsification to authorities) that the
facts stated in the document are true in all material respects
This field is required.

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