Application for Reservation of Name

PLEASE TYPE OR PRINT

APPLICANTS NAME AND STREET ADDRESS

Under 205 of the Limited Liability Company Law

NYS Department of State Division of Corporations, State Records and Uniform Commercial Code One Commerce Plaza, 99 Washington Avenue Albany, NY 12231-0001 www.dos.ny.gov

NAME TO BE RESERVED

RESERVATION IS INTENDED FOR (CHECK ONE)

New domestic limited liability company

(The Limited Liability Company Law requires that the name end with Limited Liability Company, LLC or L.L.C.)

New domestic professional service limited liability company

(The name must end with Professional Limited Liability Company or Limited Liability Company or an abbreviation in 1212(b) of the Limited Liability Company Law.)

Existing foreign limited liability company intending to apply for authority to do business in New York State Existing foreign professional service limited liability company intending to apply for authority to do business in New York State Change of name of an existing domestic or an authorized foreign limited liability company A person intending to form a foreign limited liability company which will apply for authority to do business in this state Existing foreign limited liability company intending to apply for authority to do business in New York State whose name is not available for use in New York State and must use a fictitious name Authorized foreign limited liability company intending to change its fictitious name under which it does business in this state Authorized foreign limited liability company which has changed its name in its jurisdiction, such new name not being available for use in New York State

Signature of applicant, applicants attorney or agent (If attorney or agent, so specify)

Typed/printed name of signer

INSTRUCTIONS:
1. Upon filing this application, the name will be reserved for 60 days and a certificate of reservation will be issued. 2. The certificate of reservation, which will be in the form of a receipt, must be returned with and attached to the articles of organization, application for authority, certificate of amendment or with a cancellation of the reservation. 3. The name used must be the same as appears in the reservation. 4. A $20 fee payable to the Department of State must accompany this application. NOTE: In all applications for existing domestic and foreign limited liability companies, the applicant must be the limited liability company.

DOS-1233 (Rev. 2/12)

-1-