Ab2 - Certificate (County Of Cook) printable pdf download

Ab2 - Certificate (County Of Cook)

DAVID ORR, Cook County Clerk

VITAL STATISTICS, P.O. BOX 641070, CHICAGO, IL 60664-1070

ATTN: ASSUMED NAME UNIT

FILE NO.

STATE OF ILLINOIS)

Filing fee: $50.00

COUNTY OF COOK) SS.

CERTIFICATE

It is hereby certified that the undersigned is/are conducting or transacting business under the Assumed

Name of:

(List the business name)

The business is located at the following location(s):

(List all business addresses located in Cook County)

The nature of the business being conducted or transacted is:

(Declare the type of business)

The true and real full names of all the person(s) owning, conducting or transacting the business are

as follows:

PRINT NAME

PRINT RESIDENCE ADDRESS

Contact Name & Phone Number:

Dated this

day of

, 20

SIGNATURE

STATE OF ILLINOIS

)

SIGNATURE

COUNTY OF COOK

)SS.

SIGNATURE

(ALL PERSONS MUST SIGN)

a Notary Public in and for said County and State, do hereby

certify that

is/are the same person(s) whose name(s) is/are subscribed to the foregoing instrument, and that

appeared before me this day in person and acknowledged that he/she/they has/have read and signed

said instrument, and that each of the statements contained therein are true.

(Signature of Notary Public)

My commission expires on the

day of

, 20

AB2

FILE ONE COPY

Ab2 - Certificate (County Of Cook)