Assumed Name Record (Dba) Form

Download a blank fillable Assumed Name Record (Dba) Form in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Assumed Name Record (Dba) Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ASSUMED NAME RECORD (DBA)

CERTIFICATE OF OWNERSHIP FOR BUSINESS OR PROFESSION

NOTICE: THIS CERTIFICATE OF OWNERSHIP PROPERLY EXECUTED IS TO BE FILED IMMEDIATELY WITH THE COUNTY CLERK AS PROVIDED BY LAW.

LAURA RICHARD

COUNTY CLERK, FORT BEND COUNTY, TEXAS

301 JACKSON, RICHMOND, TEXAS 77469-3108 | (281) 341-8685

NAME UNDER WHICH BUSINESS IS TO BE CONDUCTED:

________________________________________________________________________________________________

(PRINT OR TYPE NAME OF BUSINESS)

BUSINESS

ADDRESS:

CITY

STATE ________ ZIP _________

__________________________________________________________

: ____________________________

MAILING

ADDRESS:

CITY

STATE ________ ZIP _________

__________________________________________________________

: ____________________________

(IF DIFFERENT THAN BUSINESS ADDRESS)

TIME PERIOD BUSINESS NAME WILL BE USED

____________ YEARS

(not to exceed 10 years):

NOTICE: CERTIFICATES OF OWNERSHIP ARE VALID ONLY FOR A TIME PERIOD NOT TO EXCEED 10 YEARS

FROM DATE FILED WITH THE COUNTY CLERK (BUSINESS AND COMMERCE CODE SECTION 71.151)

CERTIFICATE OF OWNERSHIP

PRINT OR TYPE NAME. NOTE: SIGNATURE(S) MUST BE SIGNED IN FRONT OF A NOTARY

I/We the undersigned, are the owners(s) of the above business and my/our name(s) and address(es) given is/are true and correct and there are no other owners in

said business.

NAME: _______________________________________________________ SIGNATURE: _______________________________________________

(PRINT OWNER OR CORPORATION NAME)

______________________________________________

(IF CORPORATION, PRINT YOUR NAME AND TITLE)

ADDRESS: _______________________________________________________________________________________________________

NAME: _______________________________________________________ SIGNATURE: _______________________________________________

(PRINT ADDITIONAL OWNER’S NAME)

ADDRESS: _______________________________________________________________________________________________________

THE STATE OF TEXAS

}

COUNTY OF FORT BEND