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Application for Reservation of Corporate Name (Tennessee)

This is an application to reserve a corporation name in Tennessee. The form provided here is simply a sample of what the actual Form SS 4428 looks like.

For Office Use Only

APPLICATION FOR RESERVATION
OF CORPORATE NAME

Corporate Filings
312 Eighth Avenue North
6th Floor, William R. Snodgrass Tower
Nashville, TN 37243

To the Tennessee Secretary of State:

The undersigned hereby applies for reservation of the following corporate name for a period of four (4) months:

Please check the appropriate box:

____ This reservation is filed pursuant to Section 48-14-102 of the Tennessee Business Corporation Act.

____ This reservation is filed pursuant to Section 48-54-102 of the Tennessee Nonprofit Corporation Act.

The name and address of the applicant is:

_______________________ (Street)

_______________________ (City)

_______________________ (State)

_______________________ (Zip Code)

Date: _______________________, _______________________

(If applicant is a business)

_______________________ (Name of Business)

By: _______________________ (Signature)

Name _______________________ (typed or printed)

Signer's Capacity _______________________

(If an individual)

Applicant's Signature _______________________

Applicant's Name _______________________ (typed or printed)

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