Application For Amendment To Registration Of Assumed Business Name Form - Montana Secretary Of State
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1Prepare, sign, and submit with an original signature and filing fee.
This is the minimum information required
STATE OF MONTANA
)
(This space for Secretary of State use only
APPLICATION for AMENDMENT to REGISTRATION of
ASSUMED BUSINESS NAME
30-13-210, MCA
MAIL:
Secretary of State
P.O. Box 202801
Helena, MT
59620-2801
PHONE:
(406) 444-3665
FAX:
(406) 444-3976
WEB SITE:
sos.mt.gov
Required Filing Fee: $20.00
Folder ID Number: _______________________
24 Hour Priority Handling check box and Add $20.00
The folder number begins with an “A” and may be referenced
1 Hour Expedite Handling check box and Add $100.00
at https://
Make checks payable to Secretary of State.
If the document is hand written, please print legibly or the application may be denied.
1.
The complete Assumed Business Name prior to adoption of the amendment: _____________________________________________________
2.
If applicable: The complete new Assumed Business Name:____________________________________________________________________
3.
The name and business mailing address of the applicant currently on file with the Secretary of State:
_____________________________________________________________________________________________________________________
(Must list all owners/partners/members registered with the Montana Secretary of State prior to this amendment.)
4.
If applicable: The name(s) and business mailing address of person(s) no longer having an interest in the business being conducted under this
Assumed Business Name:
_____________________________________________________________________________________________________________________
(For additional names, attach a separate sheet of paper)
5.
If applicable: This amendment is necessary because a person who has had an interest in the business with a registered Assumed Business
Withdrawn Died
Name has:
6.
If applicable: The name(s) and business mailing address of new person(s) or entities transacting or having an interest in the business being
conducted under this Assumed Business Name:
_____________________________________________________________________________________________________________________
(For additional names, attach a separate sheet of paper)
7.
If the applicant type has changed, check only one:
Corporation Limited Liability Company Limited Liability Partnership Limited Partnership
Association (attach the names and business mailing addresses of all the members)
A Partnership (attach the names and business mailing addresses of all the partners)
Individual
8.
If applicable: The description of business is amended to read:
_____________________________________________________________________________________________________________________
9.
This amendment supersedes the original registration and all amendments to the original registration.
10. I, HEREBY SWEAR AND/OR AFFIRM, under penalty of law, including criminal prosecution, that the facts contained in this document are true.
___________________________________________________________________________________________
________________________
Signature of applicant currently on file with SOS (All Partnerships and LLPs must have at least two signatures)
Date
___________________________________________________________________ ________________________________________________
Printed Name
Title
11. Daytime Contact: Phone ____________________________________ Email ______________________________________________________
sos.mt.gov/Business/Forms
02-Amendment_to_Registration_of_Assumed_Business_Name
Revised: 12/2016
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