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DO NOT WRITE ABOVE THIS LINE; RESERVED FOR ACC USE ONLY.
APPLICATION TO RESERVE CORPORATION NAME
Read the Instructions
C006i
1.
NAME TO BE RESERVED – see
Instructions C006i
for name requirements for different entity
types. Enter the exact name or exact fictitious name to be reserved:
_______________________________________________________________________
2.
TYPE OF ENTITY – check only one to indicate the type of entity that may be formed:
FOR-PROFIT CORPORATION
INSURANCE
NONPROFIT CORPORATION
SAVINGS AND LOAN ASSOCIATION
PROFESSIONAL CORPORATION
CREDIT UNION
CLOSE CORPORATION
TRUST COMPANY
BUSINESS TRUST
COOPERATIVE MARKETING ASSOCIATION
BUSINESS DEVELOPMENT CORP.
ELECTRIC COOPERATIVE NONPROFIT MEMBERSHIP ASSOCIATION
CORPORATION SOLE
NONPROFIT ELEC. GENERATION AND TRANSMISSION COOPERATIVE CORP.
3. APPLICANT
– name and address of the individual or entity that will own the name reservation:
Name
Address 1
Address 2 (optional)
City
State or Province
Zip
Country
SIGNATURE:
By checking the box marked "I accept" below, I acknowledge under penalty of perjury
that this document together with any attachments is submitted in compliance with
Arizona law.
I ACCEPT
Signature
Printed Name
Date (mm/dd/yyyy)
REQUIRED – check only one:
I am the Applicant (I am an individual or
The Applicant is an entity and I am its duly
natural person and not an entity).
authorized agent.
Mail:
Arizona Corporation Commission
Filing Fee: $10.00 (regular processing)
Corporate Filings Section
Expedited processing – add $35.00 to filing fee.
1300 W. Washington St., Phoenix, Arizona 85007
All fees are nonrefundable - see Instructions.
Fax:
602-542-4100
Please be advised that A.C.C. forms reflect only the minimum provisions required by statute. You should seek private legal counsel for those matters that may pertain
to the individual needs of your business.
All documents filed with the Arizona Corporation Commission are public record and are open for public inspection.
If you have questions after reading the Instructions, please call 602-542-3026 or (within Arizona only) 800-345-5819.
C006.001
Arizona Corporation Commission – Corporations Division
Rev: 2010
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