Application For Cancellation Of Reserved Name For Domestic Or Foreign Form
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1APPLICATION
FOR CANCELLATION
OF RESERVED NAME
FOR DOMESTIC OR FOREIGN
STOCK & NON-STOCK
CORP, LLC, LP, LLP & STATUTORY
TRUST
Office of the Secretary of the State
30 Trinity Street / P.O. Box 150470 / Hartford, CT 061150470 / Rev. 12/1999
Space For Office Use Only
The undersigned hereby applies to cancel the reservation of the following name:
.
NAME:
!. NAME OF APPLICANT:
1. ADDRESS OF APPLICANT:
(Complete address required.
Street name, city, state & zip code)
4. EXECUTION:
SIGNATURE
OF APPLICANT
(and title if applicable)
Note: The name of the applicant must exactly match the name on record of the
party under whose name the reservation was filed.
Please type or print all information
other than the signature.
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