Notice Of Transfer Of Reserved Name {3}

Print Reset State of New Hampshire Form 3 RSA 293-A:4.02 (c) NOTICE OF TRANSFER OF RESERVED NAME OF Filing fee: $l5.00 Use black print or type. PURSUANT TO THE PROVISIONS of the New Hampshire Revised Statutes Annotated, you are hereby notified that the undersigned has transferred to whose address is the above name which was reserved in your office for the exclusive use of the undersigned on for a period of one hundred twenty days thereafter. (Note 1) (Print name of original applicant) (No. and Street) (City/Town) (State) (Zip Code) (Email Address) (Telephone Number) Its Signature (Note 2) Title Date signed: Print or type name (MMMMM DD, YYYY) Notes: 1. Enter name of individual or name of business entity in whose name certificate of reservation was issued and address. 2. Signature of original applicant. DISCLAIMER: All documents filed with the Corporation Division become public records and will be available for public inspection in either tangible or electronic form. Mail fee with DATED AND SIGNED ORIGINAL to: Corporation Division, Department of State, 107 North Main Street, Concord NH 03301-4989. Physical location: 25 Capitol Street, 3rd Floor, Concord, NH 03301. Form 3 (3/2008) American LegalNet, Inc. www.FormsWorkFlow.com