Proposed name:  
(Alternate name) 

Reserved by:  

Reserved for:  

Address of owner: City  State: zip:

  Intend to qualify a foreign corporation  whose domestic state is:
   Intend to qualify a foreign LLC whose domestic state is:
  Intend to incorporate a Vermont domestic corporation 
  Intend to organize a Vermont domestic LLC 
  Intend to register a tradename 
  Intend to register a partnership
   Intend to change the name of an existing registration. Its current name is:

Proposed business purpose:

A reservation is good for 120 days, renewable twice.  The owner of a reserved name may transfer the reservation to another person by delivering to the Secretary of State a signed notice of transfer that states the name and address of the tranferee.  Word endings, such as corporation, limited, company, limited liability company or any abbreviation thereof, cannot be used when registering a trade name, however one must be used when registering a corporation or LLC.

Signature_________________________________Title: Date:

The filing fee is $20.00.

Please file in duplicate.  This reservation will expire:__________________________________