Form Ccr - Notice Of Cancellation Of Reserved Name
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1Kentucky Secretary of State
T
G
REY
RAYSON
_____________________________________________________________________________________________________________
Division of Corporations
Notice of Cancellation of
CCR
B
F
USINESS
ILINGS
Reserved Name
P.O. Box 718
Frankfort, KY 40602
(502) 564-2848
_____________________________________________________________________________________________________________
Pursuant o the provisions of KRS 271B & 273 the undersigned applies to cancel a reserved name and for that
purpose submits the following statement:
1. The name that was reserved: _____________________________________________________________
2. The name was reserved by: ______________________________________________________________
3. The date the name reservation was filed with the Secretary of State: ______________________________
(Day/Month/Year)
Executed by the applicant on: ________________________________
________________________________________________________
(Signature)
________________________________________________________
(Print or Type Name and Title)
________________________________________________________
(Street Address)
________________________________________________________
(City, State & Zip)
Instructions:
Submit this form with one (1) exact or conformed copy.
The filing fee is $10.00
Please make check payable to the “Kentucky State Treasurer”.
All information must be completed or this document will not be accepted for filing
This form is to cancel a reservation, reserving a corporate name.
CCR (06/07)
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Parent category: Legal