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Notice of Cancellation/Transfer of Reservation of Name (Tennessee)

This is a notice of cancellation/transfer of reservation of name in Tennessee. The form provided here is simply a sample of what the actual Form SS 4406 looks like.

For Office Use Only

Notice of Cancellation/Transfer
of Reservation of Name

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

Pursuant to the provisions of Section 48-14-102(b)(c) of the Tennessee Business Corporation Act or Section 48-54-102(b)(c) of the Tennessee Nonprofit Corporation Act, the undersigned hereby submits the following application for cancellation/ transfer of reservation of name:

1. The reserved name to be canceled/transferred is:

__________________________

2. The name and address of the applicant or transferee is:

__________________________ (Name)

__________________________ (Street)

__________________________ (City)

__________________________ (State)

__________________________ (Zip Code)

Please check applicable box:

• ____ Cancellation of Reserved Name

• ____ Transfer of Reserved Name

Date: __________________________, __________________________

__________________________ Holder of Reserved Name

By: __________________________ (Signature)

Name __________________________ (typed or printed)

Signer's Capacity __________________________

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