Name Reservation Request - Nevada Secretary Of State
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1ROSS MILLER
Secretary of State
204 North Carson Street, Suite 4
Carson City, Nevada 89701-4520
(775) 684 5708
Website:
Name Reservation Request
USE BLACK INK ONLY - DO NOT HIGHLIGHT
ABOVE SPACE IS FOR OFFICE USE ONLY
I,
, hereby request that the name
be reserved for the period of 90 days.
Holder of Reservation:
Name
Address
City
State
Zip
Confirmation of Reservation:
(choose only one)
Mail to holder of reservation at the above address.
Email to the following address:
See other instructions below:
Notes:
FILING FEE: $25.00
This form must be accompanied by appropriate fee.
Nevada Secretary of State Name Reservation
Revised: 4-10-09
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