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Transfer of Reserved Name (Connecticut)

This is a transfer for reserved domestic or foreign name in Connecticut. The form provided here is simply a sample of what the actual Form SOS 003 looks like.

TRANSFER OF RESERVED NAME
FOR DOMESTIC OR FOREIGN
STOCK & NON-STOCK CORP, LLC, LP, LLP & STATUTORY TRUST

Office of the Secretary of the State
30 Trinity Street / P.O. Box 150470 / Hartford, CT 06115-0470 / Rev. 12/1999

Space For Office Use Only


The undersigned transferor hereby transfers rights associated with following reserved name to the transferee named below:

1. RESERVED NAME: ______________________

2. NAME OF TRANSFEROR: ______________________

3. NAME OF TRANSFEREE: ______________________

4. ADDRESS OF TRANSFEREE: (Complete address required.)

Street name ______________________

City ______________________

State ______________________

Zip code ______________________

5. EXECUTION:

SIGNATURE OF TRANSFEROR (and title if applicable)

______________________

Note: The transferred reservation will be effective for the remaining balance of the transferor's 120 day reservation period.

Please type or print all information other than the signature.

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