Arkansas Non Profit Corporation Reservation of Name Form

An unregistered nonprofit entity that seeks to reserve a preferred corporation name must submit this form to the Secretary of State’ office.Download

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$25.00 Filing Fee payable to Arkansas Secretary of State        RN/ Rev. 07/07 
   
 	
Application for Reservation of Entity Name 	
 
Instructions:  Mail to Secretary of State’s Business and Commercial Se rvices Division, State Capitol, Little Rock, Arkansas 
72201.  A file stamped copy, noting expirati on date will be returned for your files.   
 
The owners of a reserved name may transfer the reservation to  another person by delivering to the Secretary of State a signed 
notice of the transfer that states  the name and address of the transferee. 
The transfer shall be effective fo r the duration of the reservation. 
 	
Jurisdiction (Select One) 
   	Domestic    	 	Foreign 	 	
 
 
Entity Type (Select One) 	
   	For-Profit Corporation (§ 402 Act 958 of 1987 non-renewable) 	 
   	
Nonprofit Corporation (§ 402  Act1147 of 1993 non-renewable)    	
  	LLC (§ 104 Act 1003 of 1993 with 1 renewal of 120 days)  	 
 	
The undersigned, pursuant to the provisions  of the appropriate Act listed above, hereby requests that the following name be 
reserved for a 120 day period. 
 
 
________________________________________________________________________________________________________________ 	
Name to be reserved 
 
 	
________________________________________________________________________________________________________________  Address          City,  State Zip 
 
 
I understand that knowingly signing a false document with the intent  to file with the Arkansas Secretary of State is a Class C 
misdemeanor and is punishable by a fine up  to $100.00 and/or imprisonment up to 30 days. 
 
 
Witness the hand and seal of the applicant executed under oath, on this the  ____________ day of ________________,  
 
______________. 
 
______________________________________________________   _______________________________________________ 	
Typed  or Printed  Name of Applicant        Signature  of Applicant 
 	
A rk an sa s Se cre ta ry of Sta te
M	a rk	M	a rtin	
Busine ss&Commer cialService s,25 0\bictory Buil\fing,1401 W.Capitol ,Little Rock	
StateCapitol •Little Rock, Arkans as722011094
50168234 09•ww w.sos.arkansas.gov