C
K
OMMONWEALTH OF
ENTUCKY
T
G
, S
S
REY
RAYSON
ECRETARY OF
TATE
_________________________________________________________________________________________________________________________
Division of Corporations
Notice of Cancellation of Reserved Name
CRN
Business Filings
(Limited Liability Company or Limited Partnership)
PO Box 718
Frankfort, KY 40602
(502) 564-3490
__________________________________________________________________________________________
Pursuant to the provisions of KRS Chapter 275 and 362, the undersigned applicant applies to cancel a reserved name and,
for that purpose, submits the following statement:
1. The name reserved was____________________________________________________________________________.
2. The name was reserved by__________________________________________________________________________.
3. The date the name reservation was filed with the Office of the Secretary of State________________________________.
4. The mailing address of the applicant:
___________________________________________________________________________________________________
Street Address or Post Office Box Numbers
City
State
Zip
I declare under penalty of perjury under the laws of Kentucky that the forgoing is true and correct.
___________________________________________________________________________________________________
Signature of Applicant
Printed Name
Title
Date
(09/09)