Form Ssc-105 - Application For Reserved Name - Kentucky Secretary Of State

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COMMONWEALTH OF KENTUCKY
TREY GRAYSON
SECRETARY OF STATE
APPLICATION FOR RESERVED NAME
Pursuant to the provisions of KRS Chapter 271B, 273, 275 or 362, the undersigned hereby applies to reserve a
name and for that purpose submits the following statements:
1. ____________________________________________________________________________________
is the proposed name to be reserved
as a corporate name (KRS 271B or KRS 273)
as a limited liability company name (KRS 275)
as a limited partnership name (KRS 362)
for a non-renewable period of one hundred and twenty (120) days.
2. The name and address of the applicant is
______________________________________________________________________________
(Type or print applicant’s name)
______________________________________________________________________________
(Type or print applicant’s address)
______________________________________________________________________________
City
State
Zip Code
_______________________________________________
_______________________________________________
Signature
_______________________________________________
Print or type name and title, if applicable
Date: ________________________________, 20_______
SSC-105 (2/98)
(See attached sheet for instructions)

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