Form Bn-03 - Application To Reserve A Corporate Name

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State of North Carolina
Department of the Secretary of State
APPLICATION TO RESERVE A CORPORATE NAME
Pursuant to §55-4-02 or §55A-4-02 of the General Statutes of North Carolina, the undersigned hereby applies to the Secretary of
State to reserve the following corporate name:
1.
The corporate name to be reserved is: ________________________________________________________________________
2.
The name of the applicant is: ______________________________________________________________________________
3.
The address of the applicant is:
Street Address __________________________________________________________________________________________
City, State, Zip Code _____________________________________________________________________________________
4.
The above corporate name is to be reserved for a nonrenewable period of 120 days from the date of the filing of this application.
This the _________ day of ________________ , 20_____.
_____________________________________________
_____________________________________________
Signature
_____________________________________________
Type or Print Name and Title
NOTES:
1.
Filing fee is $10. This document and one exact copy of this application must be filed with the Secretary of
State.
(Revised January 2000)
(Form BN-03)
CORPORATIONS DIVISION
P. O. BOX 29622
RALEIGH, NC 27626-0622

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