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PENNSYLVANIA DEPARTMENT OF STATE
BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS
Read all instructions prior to completing. This form may be submitted online at https://www.corporations.pa.gov/.
Fee: $70 Check One: Name Reservation Transfer of Name Reservation
In compliance with the requirements of the applicable provisions of 15 Pa.C.S. § 208 (relating to Reservation of
name), the undersigned hereby states that:
1. The name to be reserved/transferred is: _______________________________________________________________
2. The name of the person or association reserving/transferring the name is:
__________________________________________________________________________________________________
3. The address of the person or association reserving/transferring the name is:
___________________________________________________________________________________________________________
Number and street City State Zip Co de
For TRANSFER of Name Reservation ONLY
4. The name of the person or association to whom the name reservation is being transferred is:
__________________________________________________________________________________________________
5. The address of the person or association to whom the name reservation is being transferred is:
__________________________________________________________________________________________________________
Number and street City State Zip Co de
IN TESTIMONY WHEREOF, the undersigned person or association has caused this Name Reservation/Transfer of
Reservation to be signed this ______________ day of ____________________________ , 20________ .
___________________________________________________
Name of Applicant/Transferor*
___________________________________________________
Applicant/Duly authorized representative/Transferor Signature
(A transfer of name reservation must be signed by
the person who initially reserved the name.)
___________________________________________________
Title (for association applicant only)
Return document by mail to:
Name
Address
City State Zip Code
Return document by email to: _________________________________
Name Reservation/Transfer of Reservation
DSCB:15-208
(7/1/2015)
*208*
208
DSCB:15-208–Instructions
Pennsylvania Department of State
Bureau of Corporations and Charitable Organizations
P.O. Box 8722
Harrisburg, PA 17105-8722
(717) 787-1057
web site:
www.dos.pa.gov/corps
General Information
Typewritten is preferred. If handwritten, the form must be
legible and completed in black or blue-black ink in order to
permit reproduction. The nonrefundable filing fee for this
form is $70.
Checks should be made payable to the Department of State.
Checks must contain a commercially pre-printed name and
address.
This form and all accompanying documents, including any
necessary governmental approvals, shall be mailed t o the
address stated above.
Available names will be reserved for a period of 12 0 days.
Bank name reservations will be reserved for a perio d of six
months.
NOTE: The online and customer service name availabi lity
search function only performs a preliminary search of
availability in the Bureau’s database. Upon receipt of a
registration request, the Bureau will perform a det ailed search
and confirm whether or not the requested name is av ailable.
Do not have signs, business cards, bank accounts or contracts
established in the requested business name prior to obtaining
official confirmation of acceptance of the filing f rom the
Bureau.
This form only provides for a single, one-time rese rvation of a
name. After the 120-day reservation period expires, the name
becomes available again and anyone, including the o riginal
reserver, may reserve the name. Nothing prevents t he
formation of an association for the purpose of hold ing a name
if a longer period of reservation is desired than t he 120-day
period permitted by 15 Pa.C.S. § 208.
Who should file this form?
Any individual or association seeking to reserve an association
name for a period of 120 days may file this form. F ictitious
names may not be reserved because they do not have name
exclusivity.
Applicable Law
For name reservations, in general, 15 Pa.C.S. § 208 ; for
names, in general, 15 Pa.C.S. § 414 and §§ 201-209. Statutes
are available on the Pennsylvania General Assembly website,
www.legis.state.pa.us , by following the link for Statutes.
Assocation Name Requirements
Association designators are not required to reserve an
association name. Generally, the name of an associ ation may not be the same as the name of another association
which is
already on the records of the Department of State. A domestic
filing entity, a domestic limited liability partner ship, an
electing partnership, a registered foreign associat ion or an
association registered at any time under 54 Pa.C.S. Ch. 5
(relating to corporate and other association names) may
consent to the use of its name. See DSCB:19-17.2 (C onsent to
Appropriation of Name) for consent requirements.
Attachments
The following, in addition to the filing fee, shall accompany
this form: (1) Any necessary copies of form DSCB: 19-17.2 (Consent
to Appropriation of Name).
(2) Any necessary governmental approvals.
Form Instructions
Enter the name and mailing address to which any
correspondence regarding this filing should be sent . This field
must be completed for the Bureau to return the fili ng. If the
filing is to be returned by email, an email address must be
provided. An email will be sent to address provided ,
containing a link and instructions on how a copy of the filed
document or correspondence may be downloaded. Any e mail
or mailing addresses provided on this form will bec ome part
of the filed document and therefore public record.
1. Give the name of the association to be reserved.
An association designator is not required to be par t of the
reserved name. For domestic filing entity name requ irements,
see 15 Pa.C.S. §§ 201-207. For foreign association name
requirements, see 15 Pa.C.S. § 412 and
§ 414. Statutes are available on the Pennsylvania General
Assembly website,
www.legis.state.pa.us , by following the
link for Statutes. This field is required.
2. Give the name of the person or association reques ting the
name reservation. Under the definition of “person” in 1
Pa.C.S. § 1991, a corporation, partnership, or othe r
association, as well as a natural person, may reser ve an
association name. This field is required.
3. Give the address of the person or association req uesting the
name reservation. Post office boxes are not accepta ble for any
address. Under 15 Pa.C.S. § 135(c) (relating to add resses), an
actual street or rural route box number must be use d as an
address, and the Department of State is required to refuse to
receive or file any document that sets forth only a post office
box address. This field is required.
DSCB:15-208–Instructions
4. Give the name of the person or association to whom the
reservation is transferred. This field is required for Transfer
of Name Reservation only.
5. Give the address of the person or association to whom the
reservation is transferred. This field is required for Transfer
of Name Reservation only.
Signature and Verification
The person or an authorized representative of the a ssociation
reserving the name must sign the Name Reservation. A
Transfer of a Name Reservation must be signed by th e
transferor (the individual or association that init ially reserved
the name). A Transfer of a Name Reservation may not be
signed by the transferee (the person to whom the na me is
transferred).
Signing a document delivered to the Department for filing is
an affirmation under the penalties provided in 18 P a.C.S.
§ 4904 (relating to unsworn falsification to author ities) that the
facts stated in the document are true in all materi al respects
This field is required.
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