Notice Of Transfer Of Reserved Entity Name {BE-04}

BUSINESS REGISTRATION DIVISION P. O. BOX 29622 RALEIGH, NC 27626-0622 (Revised July, 2017) (Form BE-04) STATE OF NORTH CAROLINA DEPARTMENT OF THE SECRETARY OF STATE NOTICE OF TRANSFER OF RESERVED ENTITY NAME Pursuant to 24755D-23 of the General Statutes of North Carolina, notice is hereby given that the undersigned has transferred the following reserved business entity name. 1. The reserved entity name is: 2. The reserved entity name is hereby transferred to: Name Address City, State, Zip Code 3. The date of filing of the original application to reserve this entity name was: This theday of , 20 Name of Original Applicant/Transferor Signature Type or Print Name and Title NOTES: 1. Filing fee is $10. One executed original must be filed with the Secretary of State. American LegalNet, Inc. www.FormsWorkFlow.com BUSINESS REGISTRATION DIVISION P. O. BOX 29622 RALEIGH, NC 27626-0622 (Revised July, 2017) (Form BE-04) NOTICE OF TRANSFER OF RESERVED ENTITY NAME Instructions for Filing 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). American LegalNet, Inc. www.FormsWorkFlow.com