State of Vermont

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Office of the Secretary of State

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The form below can be printed out by hitting "Print" on your web browser. Web pages tend to print out in a long format; therefore, a more compact version of this form can be saved and printed out in the following standard word processor formats:
• reservat.doc -- DOC -- Microsoft Windows, Word, WordPad format
• reservat.wpd -- WPD -- WordPerfect Document format
• reservat.rtf -- RTF -- Rich Text Format
• reservat.txt -- TXT -- simple text format

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APPLICATION TO RESERVE A NAME

Proposed name__________________________________________________________________

Applicant's name________________________________________________________________

Applicant's address______________________________________________________________
(street) (city) (state) (zip)
Reason for reserving name:

[ ] Intend to qualify a foreign corporation
[ ] Intend to register a foreign limited liability company
[ ] Intend to form a domestic corporation
[ ] Intend to register a domestic limited liability company
[ ] Intend to register a tradename
[ ] Intend to register a limited partnership

Corporate endings - such as corporation, limited, company, or any abbrev. thereof - cannot be used in a tradename.- but one must be used with all corporations, profit, and non-profit, foreign and domestic.

Once validated this reservation is good for 120 days. Such 120 day period may be renewed no more than 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 transferee.

Signature_________________________________Title_______________Date______________

do not write below this line

• DOCUMENT IS NOT VALID UNTIL OFFICIALLY STAMPED BY SEC. OF STATE

$20.00 FEE MUST BE ATTACHED TO RESERVE A CORPORATE OR LLC NAME; $10.00 FEE TO RESERVE A TRADENAME. THIS APPLICATION MUST BE TYPED OR PRINTED AND FILED IN DUPLICATE. A VALIDATED COPY OF THIS APPLICATION WILL BE RETURNED TO YOU AS YOUR PROOF OF RESERVATION.EXPEDITE RECEIPT OF YOUR COPY SEND A SELF-ADDRESSED ENVELOPE.