Application For Reservation Of Entity Name Form - Arkansas Secretary Of State
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1APPLICATION FOR RESERVATION OF ENTITY NAME
(PLEASE TYPE OR PRINT CLEARLY IN INK)
The owners of a reserved name may transfer the reservation to another person by delivering to the Secretary of State a signed
notice of the transfer that states the name and address of the transferee.
The transfer shall be effective for the duration of the reservation.
Entity Type (Select One)
For-Profit Corporation (§ 402 Act 958 of 1987 non-renewable)
Nonprofit Corporation (§ 402 Act1147 of 1993 non-renewable)
LLC (§ 104 Act 1003 of 1993 with 1 renewal of 120 days)
LP/LLLP (§ 109 Act 15 of 2007 renewable for 120 days)
The undersigned, pursuant to the provisions of the appropriate Act listed above, hereby requests that the following name be
reserved for a 120 day period.
________________________________________________________________________________________________________________
Name to be reserved
________________________________________________________________________________________________________________
Address
City, State Zip
I understand that knowingly signing a false document with the intent to file with the Arkansas Secretary of State is a Class C
misdemeanor and is punishable by a fine up to $100.00 and/or imprisonment up to 30 days.
Executed this ___________________ day of _____________________, ______________________.
______________________________________________________
_______________________________________________
Typed or Printed Name of Applicant
Signature of Applicant
$25.00 Filing Fee payable to Arkansas Secretary of State
RN/ Rev. 08/07
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