Application for Reservation of Name
(Submit fee of $25.00 for each business entity except Limited Liability Partnerships)
(Submit a fee of $30.00 for each Limited Liability Partnership)
The undersigned requests that the following name be reserved for designating a corporation, limited partnership, limited liability com-
pany, or limited liability partnership.
Name to be reserved:
This name reservation is for a 60-day period. You may submit additional name reservations for the same name, but please note the
name you are reserving may only be reserved for a maximum of 180 days per Missouri statutes.
In Affirmation thereof, the facts stated above are true and correct:
(The undersigned understands that false statements made in this filing are subject to the penalties provided under Section 575.040, RSMo)
Reserved by:
Signature Printed Name Title Date
Street City/State/Zip
State of Missouri
Jason Kander, Secretary of State
Corporations Division
PO Box 778 / 600 W. Main St., Rm. 322
Jefferson City, MO 65102
BE-1 (11/2008)
Name and address to return filed document:
Name:
Address:
City, State, and Zip Code:
This form is designed to be filled out online for your convenience.
Please read the instructions carefully. Complete the necessary
information, print, sign and mail.