COMMONWEALTH OF KENTUCKY
TREY GRAYSON
SECRETARY OF STATE
CERTIFICATE OF WITHDRAWAL OF ASSUMED NAME
This certifies that the assumed name of
_________________________________________________________________________________________________
[Assumed name under which the business is being conducted]
has been discontinued by
_________________________________________________________________________________________________
[Real name - KRS 365.015(1)]
which is the “real name” of
[YOU MUST CHECK ONE]
______ a Domestic General Partnership
______ a Foreign General Partnership
______ a Domestic Registered Limited Liability Partnership
______ a Foreign Registered Limited Liability Partnership
______ a Domestic Limited Partnership
______ a Foreign Limited Partnership
______ a Domestic Business Trust
______ a Foreign Business Trust
______ a Domestic Corporation
______ a Foreign Corporation
______ a Domestic Limited Liability Company
______ a Foreign Limited Liability Company
______ a Joint Venture
organized and existing in the state or country of _________________________________, and whose address is
__________________________________________________________________________________________________.
Street address, if any
City
State
Zip Code
The certificate of assumed name was filed with the Secretary of State on ________________________________________.
The certificate of withdrawal of assumed name is executed by
___________________________________________
____________________________________________
Signature
Signature
___________________________________________
____________________________________________
Print or type name and title
Print or type name and title
___________________________________________
____________________________________________
Date
Date
SSW-266 (7/98)
(See attached sheet for instructions)