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Kentucky Foreign Corporation Name Reservation Form

In the case of a foreign corporation in the State of Kentucky wanting to reserve a name before officially registering that name, the following form has to be completed and submitted along with a $40 filing fee.

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(01/12	) 	
 	
 	
C	OMMONWEALTH OF 	K	ENTUCKY 	 	
ALISON 	LUNDERGAN 	G	RIMES	, SECRETARY OF 	STATE	 	
____________________________________________________________________________________________	_____________________________	 	
Division of 	Business Filings	 	
Business Filings	 	
PO Box 718	 	
Fra	nkfort, KY 40602	 	
(502) 564	-3490	 	
www.sos.ky.gov	 	
____________________________________________________________	_____________________________	 	
Pursuant  to  the  provisions  of 	KRS  14A  and 	KRS  Chapter 	271B,  273,  274,  275,  362  or  386	,  the  undersigned  applies  for 	
regi	stration or renewal and	, for that purpose	, submits the following statements:	 	
 
1. 	The entity is a :	   	  profit corporation (KRS 271B). 	  	          	 	  nonprofit corporation (KRS 273).  	 	
     	  professional service corporation (KRS 274).	     	  business tr	ust (KRS 386).   	 	
     	  limited liability company (KRS 275).  	 	           	  limited partnership (KRS 362).	 	    	 	
     	  professional limited liability company (KRS 275).	 	
2.  The activity request is: 	 	
 	
 	Registration 	 	 	
 	
 	Renewal	 	
 
3. The	 name of the 	entity	 is _______________	_____	_________	__________________	___	________________________.	 	
 
4. The state or country of organization is __________________	_________	_____________________________________.	 	
 
5. The date of organization is ____________________________________	________	____________________________.	 	
 
6. The mailing address of the 	entity	 is 	
 
______________________________________	_______	____________________________________________________	Str	eet Address or Post Office Box Numbers	 	 	 	City	 	 	 	State	 	 	 	Zip Code	 	
 
7. The nat	ure of the business of the 	entity	 is _______________	______________________________________________	 	                                                   	            	(Please print brief description)	 	
_____________________________________________________________	___________________________	_________	 	
 
________________________________________________________________________________________	_________	 	
 
8. 	This application will be effective upon filing, unless a delayed effective date and/or time is provided.  The effect	ive 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)	 	
We/	I de	clare under penalty of perjury under the laws of Kentucky that the forgoing is true and correct.	 	
____	_______________________________ 	______	__	_______________ __________________ 	___________	 	
Signature of Authorized Agent	 	 	 	Printed Name 	 	 	 	Title 	 	 	 	Date	 	 	
 	 	  	   	
Registration or Renewal	 of Entity Name	  	 	REG	 	
(Foreign 	Business 	Entity	)

(01/12	) 	
 	
FILING INSTRUCTIONS 	 	
REGISTRATION 	OR 	RENEWAL OF ENTITY NA	ME	 	
 
TYPE OF FORMATION	 	
The corporation must indicate if it is a corporation (KRS 271B), a nonprofit corporation (KRS 273), a professional service co	rporation 	 	
(KR	S 274), a business trust (KRS 386	), a limited liability company (KRS 275) or a limited partnership (KRS 362) by checking the 	
appropriate box.	 	
 
REGISTRATION OR RENEWAL	 	
If the limited liability company is applying for renewal of registration of company name, check appropriate block.  Please no	te: A 	
registered name is effective when filed with the Secretary of State and expires on December 31	st of the same year.  A registered name 	
may be renewed for successive years between October 1	st and December 31	st of the preceding year.  When the renewal i	s effective, it 	
renews the company name registration for the following calendar year.	 	
 
DATE OF FORMATION	 	
The date of 	formation is	 the date the 	entity	 was organized in the state or country of its organization. 	 	
 
PRINCIPAL OFFICE ADDRESS	 	
The principal office	 is the office (in or out of this state) so designated in writing with the Office of the Secretary of State where the 	
principal designated office of the business entity is located.  This address is where all correspondence from the Office of t	he Secretary 	
of State (See Document Delivery) will be 	mailed	.  	
NATURE OF BUSINESS	 	
The limited liability company must give a brief description of the nature of the business in which it is engaged.	 	
 
DELAYED EFFECTIVE DATE AND TIME	 	
The document will be effective on the da	te and time of filing, unless a delayed effective date and/or time is specified.  The effective date 	
or the delayed effective date cannot be prior to the date the application is filed.  A delayed effective date may not be late	r than the 90	th 	
day after the 	date of filing. 	 	
 
WHO MAY SIGN 	 	
The document may be signed by the chairman of the board, president, officer, manager, member general partner, trustee or auth	orized 	
representative.	 	
 
NUMBER OF COPIES	 	
If filing via mail or in person, one exact or conformed co	py of the documents with the filing fee must be submitted to the address below.  	
To make a copy of the filing for delivery to the local county clerk’s office, visit www.sos.ky.gov and print a copy from the 	organization 	
search tool.	 	
 
DOCUMENT DELIVERY	 	
A fil	e stamped postcard will be sent to the principal office address.  If the applicant wishes for the document to be sent to an a	lternate 	
address other than the principal office, a request must be submitted in writing affirming that request.  Alternate address	 requests must 	
be submitted with each document filed with the Office of the Secretary of State.   	 	
FILING FEE	 	
The filing fee for 	this document 	is $	36	.00.  	Checks should be made payable to the "Kentucky State Treasurer."	 	
 
MAILING ADDRESS	 	 	 	OFFICE LOCATION	 	
Alison Lundergan Grimes	  	 	Room 154, Capitol Building	 	
Secretary of State	 	 	 	700 Capital Avenue	 	
P. O. Box 718	 	 	 	 	Frankfort, KY  40601	 	
Frankfort, KY  40602	-0718	  	 	Hours of Operation: 8:00 AM	-4:30 PM ET	 	
 
CONTACT INFORMATION AND NAME AVAILABILITY	 	
If you have any 	questions, need additional forms or wish to search for name availability, please feel free to visit our website at 	
www.sos.ky.gov or call (502) 564	-3490.
Next: Kentucky Non-Profit Articles of Incorporation Form Previous: Kentucky Professional Articles of Incorporation Form
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