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DO NOT WRITE ABOVE THIS LINE; RESERVED FOR ACC USE ONLY.
APPLICATION TO RESERVE LIMITED LIABILITY COMPANY NAME Read the Instructions
1. NAME TO BE RESERVED – see Instructions L001i for name requirements for different entity types. Enter the exact name or exact fictitious name to be reserved:
_______________________________________________________________________
2. TYPE OF ENTITY – check only one to indicate the type of entity that may be formed: LIMITED LIABILITY COMPANY PROFESSIONAL LIMITED LIABILITY COMPANY
3. APPLICANT – name and address of the individual or entity that will own the name reservation:
Name
Address 1
Address 2 (optional)
City State or Province Zip
Country
SIGNATURE:
I ACCEPT
Signature Printed Name Date (mm/dd/yyyy)
REQUIRED – check only one:
I am the Applicant (I am an individual or natural person and not an entity).
The Applicant is an entity and I am its duly authorized agent.
Filing Fee: $10.00 (regular processing) Expedited processing – add $35.00 to filing fee. All fees are nonrefundable - see Instructions.
Mail: Arizona Corporation Commission Corporate Filings Section 1300 W. Washington St., Phoenix, Arizona 85007 Fax: 602-542-4100
Please be advised that A.C.C. forms reflect only the minimum provisions required by statute. You should seek private legal counsel for those matters that may pertain to the individual needs of your business. All documents filed with the Arizona Corporation Commission are public record and are open for public inspection. If you have questions after reading the Instructions, please call 602-542-3026 or (within Arizona only) 800-345-5819.
L001.002 Arizona Corporation Commission – Corporations Division Rev: 7/2017 Page 1 of 1
L001i
By checking the box marked "I accept" below, I acknowledge under penalty of law that this document together with any attachments is submitted in compliance with Arizona law.