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 clerkâs 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.
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