THE REPUBLIC OF UGANDA APPLICATION FORM FOR RESERVATION OF NAME (Under Section 36 of the Companies Act No.1 of 2012 & Section 4(b)(1b) of NGO Registration Amendment Act, 2006) TO : The Registrar of Companies P O Box 6848 KAMPALA FROM : Name/s:……………………………………………………………………………………………….. …………………………………………………………………………………………………………… Tel. No/s :………………………………………………………………………………………………………… Email/s : …………………………………………………………………………………………………………… Signature/s : …………………………………………………………………………………………………………… Being promoters of an Entity : (please tick and indicate if it is a change of name.) Company limited by Shares Company limited by Guarantee Non-Governmental Organisation Apply for the reservation of a name(Indicate in order of priority choice) NAME PROPOSED NAME CHOICE 1st Choice 2nd Choice 3rd Choice Date ………………………………………………………………………………………………………… +NB: The Reservation Is Valid For Only 30 Days from Date Of Approval