Form Not - Transfer Of Reserved Name (Domestic And Foreign Entity)
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1
2C
K
OMMONWEALTH OF
ENTUCKY
A
L
G
, S
S
LISON
UNDERGAN
RIMES
ECRETARY OF
TATE
_________________________________________________________________________________________________________________________
Division of
Business Filings
Transfer of Reserved Name
NOT
Business Filings
PO Box 718
(Domestic and Foreign Entity)
Frankfort, KY 40602
(502) 564-3490
__________________________________________________________________________________________
Pursuant to the provisions of KRS 14A and KRS Chapter 271B, 273, 274, 275, 362 or 386 the undersigned applies to
transfer a reserved name and, for that purpose, submits the following statements:
1. The reserved name is_____________________________________________________________________________.
(Name must be identical to the name on record with the Secretary of State.)
2. The name was reserved by ________________________________________________________________________.
(Applicant’s name)
3. The name as reserved is hereby transferred to _________________________________________________________.
(Transferee’s name)
4. The mailing address of the transferee is:
_________________________________________________________________________________________________
Street Address or PO Box Numbers
City
State
Zip Code
5. The date of filing of the original application to reserve the name was ________________________________________.
6. This application will be effective upon filing, unless a delayed effective date and/or time is provided. The effective date
or the delayed effective date cannot be prior to the date the application is filed. The date and/or time is______________.
(Delayed effective date
and/or time)
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
(01/12)
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