Natalie E. Tennant
Penney Barker, Manager
Secretary of State
Corporations Division
1900 Kanawha Blvd E.
Tel: (304)558-8000
Bldg 1, Suite 157-K
Fax: (304)558-8381
Charleston, WV 25305
Website:
E-mail:
APPLICATION TO
FILE ONE ORIGINAL
Office Hrs: Monday - Friday
(Two if you want a filed
REGISTER A COMPANY
8:30 a.m. – 5:00 p.m. ET
stamped copy returned to you)
NAME
FEE: $25.00 -
NEW registration
$10.00 – RENEWAL
registration
A CERTIFICATE OF EXISTENCE FROM THE STATE IN WHICH THE ENTITY WAS ORIGINALLY
ORGANIZED IS REQUIRED TO COMPLETE THE APPLICATION PROCESS.
1.
The entity applying for name registration in West Virginia is registered in its home State as a:
Corporation
Limited Partnership
Limited Liability Company
Business Trust
Voluntary Association
Limited Liability Partnership
2.
The current application is for:
New
name registration
Renewal of name registration
3.
Name to be registered: ______________________________________________________________________
4.
Address of company:
_______________________________________________
___________________________________________________
Street
City/State/Zip
5.
Incorporation State: ____________________ Date of Original Company Formation: ___________________
6.
The entity is engaged in the business activity of: __________________________________________________
7.
The name and address of the applicant (person or company) is:
____________________________ _____________________________ ______________________________
Name
Address
City/State/Zip
8.
Signature information (see *Important Legal Notice Regarding Signature in the attached instructions):
__________________________________________________________
__________________________
Signature
Date
ACKNOWLEDGEMENT
(For office use only)
TO THE APPLICANT:
The name is registered for the applicant from the date of this filing until December 31, ______. To continue
Protection for an additional year, renew the registration before that date. (Renewal period is between Oct. 1
Dec. 31)
The name cannot be registered because it is not distinguishable from a name currently being used. The
registration fee will be returned or refunded to the applicant.
Date Filed: ________________________
Approved/Filed by: _____________________________________
Business & Licensing Clerk
Form NR-2
Issued by the Office of the Secretary of State
Revised 5/13