"Statement of Reservation of Name - Sample" - Colorado

Statement of Reservation of Name - Sample is a legal document that was released by the Colorado Secretary of State - a government authority operating within Colorado.

Form Details:

  • Released on January 9, 2017;
  • The latest edition currently provided by the Colorado Secretary of State;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Colorado Secretary of State.

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Download "Statement of Reservation of Name - Sample" - Colorado

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Form must be filed electronically.
Paper forms are not accepted.
This copy is a sample and cannot be submitted for filing.
Statement of Reservation of Name
filed pursuant to §7-90-301, et seq. and §7-90-602 of the Colorado Revised Statutes (C.R.S.)
1. The person stated as the applicant below is applying to reserve, for a 120 day period, the name stated
below for use as an entity name.
2. The name being reserved is
______________________________________________________.
3. The name of applicant (if an individual) is:
____________________ _____________ ______________ _____ .
(Last)
(First)
(Middle)
(Suffix)
OR (if a business organization):
______________________________________________________.
4. The mailing address of applicant is:
______________________________________________________
(Street name and number or Post Office Box information)
______________________________________________________
__________________________ ____ ____________________
(City)
(State)
(Postal/Zip Code)
_______________________ ______________ .
(Province – if applicable)
(Country – if not US)
Notice:
Causing this document to be delivered to the secretary of state for filing shall constitute the affirmation or
acknowledgment of each individual causing such delivery, under penalties of perjury, that the document is the
individual's act and deed, or that the individual in good faith believes the document is the act and deed of the person
on whose behalf the individual is causing the document to be delivered for filing, taken in conformity with the
requirements of part 3 of article 90 of title 7, C.R.S., the constituent documents, and the organic statutes, and that the
individual in good faith believes the facts stated in the document are true and the document complies with the
requirements of that Part, the constituent documents, and the organic statutes.
This perjury notice applies to each individual who causes this document to be delivered to the secretary of state,
whether or not such individual is named in the document as one who has caused it to be delivered.
5. The true name and mailing
address of the individual causing
the document to be delivered for
filing are
____________________ ______________ ______________ _____
(Last)
(First)
(Middle)
(Suffix)
______________________________________________________
(Street name and number or Post Office Box information)
______________________________________________________
__________________________ ____ ____________________
(City)
(State)
(Postal/Zip Code)
_______________________ ______________ .
(Province – if applicable)
(Country – if not US)
RS
Page 1 of 2
Rev. 1/9/2017
Form must be filed electronically.
Paper forms are not accepted.
This copy is a sample and cannot be submitted for filing.
Statement of Reservation of Name
filed pursuant to §7-90-301, et seq. and §7-90-602 of the Colorado Revised Statutes (C.R.S.)
1. The person stated as the applicant below is applying to reserve, for a 120 day period, the name stated
below for use as an entity name.
2. The name being reserved is
______________________________________________________.
3. The name of applicant (if an individual) is:
____________________ _____________ ______________ _____ .
(Last)
(First)
(Middle)
(Suffix)
OR (if a business organization):
______________________________________________________.
4. The mailing address of applicant is:
______________________________________________________
(Street name and number or Post Office Box information)
______________________________________________________
__________________________ ____ ____________________
(City)
(State)
(Postal/Zip Code)
_______________________ ______________ .
(Province – if applicable)
(Country – if not US)
Notice:
Causing this document to be delivered to the secretary of state for filing shall constitute the affirmation or
acknowledgment of each individual causing such delivery, under penalties of perjury, that the document is the
individual's act and deed, or that the individual in good faith believes the document is the act and deed of the person
on whose behalf the individual is causing the document to be delivered for filing, taken in conformity with the
requirements of part 3 of article 90 of title 7, C.R.S., the constituent documents, and the organic statutes, and that the
individual in good faith believes the facts stated in the document are true and the document complies with the
requirements of that Part, the constituent documents, and the organic statutes.
This perjury notice applies to each individual who causes this document to be delivered to the secretary of state,
whether or not such individual is named in the document as one who has caused it to be delivered.
5. The true name and mailing
address of the individual causing
the document to be delivered for
filing are
____________________ ______________ ______________ _____
(Last)
(First)
(Middle)
(Suffix)
______________________________________________________
(Street name and number or Post Office Box information)
______________________________________________________
__________________________ ____ ____________________
(City)
(State)
(Postal/Zip Code)
_______________________ ______________ .
(Province – if applicable)
(Country – if not US)
RS
Page 1 of 2
Rev. 1/9/2017
(If the following statement applies, adopt the statement by marking the box and include an attachment.)
This document contains the true name and mailing address of one or more additional individuals causing the
document to be delivered for filing.
Disclaimer:
This form/cover sheet, and any related instructions, are not intended to provide legal, business or tax advice, and are
furnished without representation or warranty. While this form/cover sheet is believed to satisfy minimum legal
requirements as of its revision date, compliance with applicable law, as the same may be amended from time to
time, remains the responsibility of the user of this form/cover sheet. Questions should be addressed to the user’s
legal, business or tax advisor(s).
RS
Page 2 of 2
Rev. 1/9/2017
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