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DO NOT WRITE ABOVE THIS LINE; RESERVED FOR ACC USE ONLY. APPLICATION TO RESERVE CORPORATION NAME 1. NAME TO BE RESERVED – see Instructions C006i for name requirements for different entity types. Enter the exact name or exact fictitious name to be reserved: _______________________________________________________________________ 2. TYPE OF ENTITY – check only one to indicate the type of entity that may be formed: FOR-PROFIT CORPORATION INSURANCE NONPROFIT CORPORATION SAVINGS AND LOAN ASSOCIATION PROFESSIONAL CORPORATION CREDIT UNION CLOSE CORPORATION TRUST COMPANY BUSINESS TRUST COOPERATIVE MARKETING ASSOCIATION BUSINESS DEVELOPMENT CORP. ELECTRIC COOPERATIVE NONPROFIT MEMBERSHIP ASSOCIATION CORPORATION SOLE NONPROFIT ELEC. GENERATION AND TRANSMISSION COOPERATIVE CORP. 3. APPLICANT – name and address of the individual or entity that will own the name reservation: Name Address 1 Address 2 (optional) City State or Province Zip Country SIGNATURE: I ACCEPT Signature Printed Name Date (mm/dd/yyyy) REQUIRED – check only one: I am the Applicant (I am an individual or natural person and not an entity). The Applicant is an entity and I am its duly authorized agent. Filing Fee: $10.00 (regular processing) Expedited processing – add $35.00 to filing fee. All fees are nonrefundable - see Instructions. Mail: Arizona Corporation Commission Corporate Filings Section 1300 W. Washington St., Phoenix, Arizona 85007 Fax: 602-542-4100 Please be advised that A.C.C. forms reflect only the minimum provisions required by statute. You should seek private legal counsel for those matters that may pertain to the individual needs of your business. All documents filed with the Arizona Corporation Commission are public record and are open for public inspection. If you have questions after reading the Instructions, please call 602-542-3026 or (within Arizona only) 800-345-5819. C006.001 Arizona Corporation Commission – Corporations Division Rev: 2010 Read the Instructions Page 1 of 1 C006i By checking the box marked "I accept" below, I acknowledge under penalty of perjury that this document together with any attachments is submitted in compliance with Arizona law. Clear Form Print Form