Application To Register A Company Name {NR-2}

FILE ONE ORIGINAL(Two if you want a filed stamped copy returned to you) FEE: $25.00 - NEW registration$10.00 - RENEWAL registrationA CERTIFICATE OF EXISTENCE FROM THE STATE IN WHICH THE ENTITY WAS ORIGINALLY ORGANIZED IS REQUIRED TO COMPLETE THE APPLICATION PROCESS. 1.The entity applying for name registration in West Virginia is registered in its home State as a:Corporation Limited Partnership Limited Liability Company Business Trust Voluntary Association Limited Liability Partnership 2.The current application is for:New name registration Renewalof name registration 3.Nametoberegistered: 4.Address of company:Street City/State/Zip 5.IncorporationState: DateofOriginalCompanyFormation: 6.Theentityisengagedinthebusinessactivityof: 7.The name and address of the applicant (person or company) is:Name Address City/State/Zip 8.Signature information (see *Important Legal Notice Regarding Signature in the attached instructions): Signature DateTO THE APPLICANT:ACKNOWLEDGEMENT (For office use only) The name is registered for the applicant from the date of this filing until December 31, . To continue Protection for an additional year, renew the registration before that date. (Renewal period is between Oct. 1 Dec. 31) The name cannot be registered because it is not distinguishable from a name currently being used. The registration fee will be returned or refunded to the applicant.DateFiled: Approved/Filedby: Business & Licensing Clerk Important Note: This form is a public document. Please do NOT provide any personal identifiable information on this form such as social security number, bank account numbers, credit card numbers, tax identification or driver's license numbers.APPLICATION TO REGISTER A COMPANY NAMEForm NR-2 Rev. 11/2017West Virginia Secretary of State Business & Licensing Division Tel: (304)558-8000 Fax: (304)558-8381 Website: www.wvsos.gov INSTRUCTIONS FOR FILING NAME REGISTRATION BEFORE you fill out the application: Your corporate name can be registered only if it is available 226 that is, if the name is not the same as and is distinguishable from any other name which has been reserved or filed. Before you prepare this application, call the Corporations Division at (304)558-8000 to find out if your name is available. A telephone check on availability of a name is NOT a guarantee the name will be available when the application is received by this office. Once your name registration is approved, you are guaranteed exclusive use of the name until the 31st of December following your registration. The registration may be renewed between October 1 and December 31 for an additional year. If the registration lapses, the company must file a new registration again to re-establish protection. FILLING OUT THE APPLICATION: (All requested information is required by law.) Section 1. Please check your company type. The types listed are the only ones for which a name can be registered in West Virginia. Section 2. Check 223New224 if no registration is currently in effect. Check 223Renewal224 if the registration is now in effect. Section 3. List the name exactly as it appears on your Certificate of Existence. Section 4. List the address of the principal office of the company. Section 5. List the State in which the company is organized and the date of its original formation. Section 6. State the business purpose (activity) of the company. Section 7. List the name of the applicant (person or company). Section 8. Signature of the applicant and Date the application is signed. *Important Legal Notice Regarding Signature: Corporations/Voluntary Associations/Business Trusts/Unincorporated Nonprofit Associations/Limited Partnerships - Per West Virginia Code 24731D-1-129. Penalty for signing false document. Any person who signs a document he or she knows is false in any material respect and knows that the document is to be delivered to the Secretary of State for filing is guilty of a misdemeanor and, upon conviction thereof, shall be fined not more than one thousand dollars or confined in the county or regional jail not more than one year, or both. Limited Liability Companies/Limited Liability Partnerships - Per West Virginia Code 24731B-2-209. Liability for false statement in filed record. If a record authorized or required to be filed under this chapter contains a false statement, one who suffers loss by reliance on the statement may recover damages for the loss from a person who signed the record or caused another to sign it on the person's behalf and knew the statement to be false at the time the record was signed. Mail completed form, CERTIFICATE OF EXISTENCE and filing fee of $25 (for NEWregistration) or $10 (for RENEWAL of name registration) to the address at top of form.Make checks payable to the West Virginia Secretary of State. Send one original and one copy if you would like to have a 223filed224 stamped copy returned to you. Important Note: This form is a public document. Please do NOT provide any personal identifiable information on this formsuch as social security number, bank account numbers, credit card numbers, tax identification or driver's license numbers. CHOOSE ONE OF THE FOLLOWING PROCESSING SERVICES: 1 EXPEDITED SERVICE (24-hour, 2-hour and 1-hour; *Requires standard filing fee plus additional expedite fee, see below) West Virginia Secretary of State Business & Licensing Division Tel: (304) 558-8000 Fax: (304) 558-8381 Website: www.wvsos.gov Filing Submission Instructions - Business DivisionSUBMIT THE COMPLETED APPLICATION WITH THE CUSTOMER ORDER REQUEST FORM TO ONE OF THE OFFICES BELOW. CHOOSE EXPEDITED OR STANDARD PROCESSING SERVICE. IF NOT USING THE CUSTOMER ORDER REQUEST FORM AND YOU ARE REQUESTING EXPEDITED SERVICE, YOU MUST INCLUDE THE WORD "EXPEDITE" AND THE LEVEL OF EXPEDITED SERVICE BEING REQUESTED (24-HOUR, 2-HOUR OR 1-HOUR) IN YOUR CORRESPONDENCE. BE SURE TO INCLUDE THE CORRECT ADDITIONAL EXPEDITED FEE. THIS FEE IS IN ADDITION TO THE REGULAR FILING FEE (SEE FEES BELOW).BUSINESS SERVICE CENTERS Standard and Expedited Filings Charleston Office One-Stop Business Center 1615 Washington Street East Charleston, WV 25311 Phone: (304) 558-8000 Fax: (304) 558-8381 Hours: Mon. - Fri. 8:30a - 5:00p EST Clarksburg Office North Central WV Business Center 200 West Main Street Clarksburg, WV 26301 Phone: (304) 367-2775 Fax: (304) 627-2243 Hours: Mon. -Fri. 9:00a - 5:00p EST Martinsburg Office Eastern Panhandle Business Center 229 E. Martin Street Martinsburg, WV 25401 Phone: TBA Fax: TBA Hours: Mon. - Fri. 9:00a - 5:00p ESTIMPORTANT: READ ALL INSTRUCTIONS CAREFULLY BEFORE COMPLETING FORMS. Please follow the instructions included with the application. Failure to include any of the required information on the form may cause the filing to be rejected.All forms may be downloaded from our web site www.wvsos.gov . Rev. 11/2017 *Fee$ 25.00 $250.00 $500.00 Expedite Service 24-Hour 2-Hour 1-HourEXPEDITED SERVICE requests may be submitted by: - E-mail to efilings@wvsos.gov - Fax - Walk in delivery 2 STANDARD PROCESSING (5-10 business days) SUBMIT COMPLETED FILING TO ONE OF THE BUSINESS CENTERS BELOW: INCLUDE PAYMENT: Be sure to enclose the correct filing fee with your filing. If paying by credit card, be sure to include the e-Payment Authorization form with your filing. Your filing will be rejected if the payment is not included or if the e-Payment Authorization form is not included if paying by credit card. Standard filing fees apply.STANDARD PROCESSING requests may be submitted by: - E-mail to CorpFilings@wvsos.gov - Fax - Walk in delivery (drop off service only filed within 5-10 business days) READ CAREFULLY BEFORE SUBMITTING - Expedite service is NOT AVAILABLE for the following filings: West Virginia Secretary of State Business & Licensing Division Tel: (304)558-8000 Fax: (304)558-8381 Website: www.wvsos.gov Customer Order RequestSUBMIT THIS COMPLETED FORM WITH YOUR FILING. Order Processing Requested*: * * * Expedite Processing Requires Additional Fees * * * Standard Processing** 24-HOUR Expedite*** 2-HOUR Expedite 1-HOUR Expedite Name of Entity: Return filing to: (Return Address) Contact Name: Phone: Return Delivery Options: Email or Fax options do n