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Notice of Transfer of Reserved Corporate Name (North Carolina)

This form is to transfer reserved a corporate name in North Carolina. The form provided here is simply a sample of what the actual Form BN-04 looks like.

State of North Carolina
Department of the Secretary of State

CORPORATIONS DIVISION
P. O. BOX 29622
RALEIGH, NC 27626-0622

NOTICE OF TRANSFER OF RESERVED CORPORATE NAME

Pursuant to §55-4-02(b) or §55A-4-02(b) of the General Statutes of North Carolina, notice is hereby given that the undersigned has transferred the following reserved corporate name.

1. The reserved corporate name is: ________________________

2. The reserved corporate name is hereby transferred to: ____________________________________

Name ____________________________________

Address ____________________________________

City ____________________________________

State ____________________________________

Zip Code ____________________________________

3. The date of filing of the original application to reserve this corporate name was: _____________________________________

This the ______ day of ________________________, 20_____

____________________________________
Name of Original Applicant/Transferor

____________________________________
Signature

____________________________________
Type or Print Name and Title


NOTE:

1. Filing fee is $10. One executed original and one exact or conformed copy of this notice must be filed with the Secretary of State.


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INSTRUCTIONS FOR FILLING OUT THIS FORM
-----------------------------

Item 1 Enter the complete name exactly as it appears on the reservation.

Item 2 Enter the name and complete address of the person to whom the reserved name is being transferred.

Item 3 Enter the date the original reservation was filed.

Date and Execution

Enter the date the document was executed.

In the blanks provided enter:

• The name of the entity or individual that is the transferor or owner of the reserved name.
• The signature of the transferor or of the representative of the entity transferring the name.
• The name and title of the above-signed representative (only if an entity is the transferor).

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