Certificate Of Doing Business Under Assumed Name Otsego County printable pdf download

Certificate Of Doing Business Under Assumed Name Otsego County

Certificate of Doing Business Under Assumed Name (“D/B/A”)

Otsego County Clerk’s Office, 197 Main Street, Cooperstown, NY 13326 (607)547-4276

Kathleen Sinnott Gardner, Otsego County Clerk

PURSUANT TO SECTION 130 OF THE GENERAL BUSINESS LAW OF NEW YORK STATE

1. I certify that my name is (print name)

_______________________________________________________________

2. I live at

________________________________________________________________________________________

3. I intend to do business in Otsego County at the following address:

______________________________________________________________________________________________

in (city,town,village)

New York, (zip)

__________________________________,

___________________________

4. I will do business under the name

___________________________________________________________________

_______________________________________________________________________________________________

5. I further certify that I am the successor in interest to the following person, who formerly used this

name or names to

conduct/transact business (person’s name)

_____________________________________________________________

My Signature:

Date

________________________________________

: ________________________________

*Print or type name under signature

*If under 21 years of age, state “I am ____ years of age”

STATE OF NEW YORK

)

COUNTY OF_______________

)

On this ______ day of _______________, 20___, before me, the undersigned personally appeared

___________________________________________________________________________________________________________

personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the

within instrument and acknowledged to me that he/she/their executed the same in his/her/their capacity and that by his/her/their

signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instruments.

_______________________________________________________________

(signature of individual taking acknowledgment) - Notary Public

Certificate Of Doing Business Under Assumed Name Otsego County