Business Name Reservation Request Form
(Corporation, Limited Liability Company, or Limited Partnership Names)
The proposed name is being reserved for use by:
Your Name
Phone Number
Fax
Name To Be Reserved:
1st Choice
2nd Choice
3rd Choice
Please fill in your email
Type of Entity
If the proposed name is being reserved for the purpose of reviving a suspended or forfeited entity, check the box and include the entity number
Entity Number
Reservation Fee: The fee for reserving a corporation, limited liability company or limited partnership name is $10.00 (per reserved name).
Your signature