Certificate Of Business Template - Fictitious Firm Name - Lincoln County Clerk, Pioche, Nv

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Certificate of Business: Fictitious Firm Name

Please Return with $20.00 to:

Please Select One:

Lincoln County Clerk

P.O. Box 90

___New Application

Pioche, NV 89043

___Renewal of Application

___Add an individual or corporation

Please Print or Type

The expiration date for such certificates shall be the last day of the sixtieth month from the date of filing.

The undersigned do/does hereby certify that __________________________________________________________

(Name of individual, corporation, partnership, or trust)

with mailing address of _________________________________,______________________,________,__________

(Mailing Address for notification of renewal) (Street)

(City)

(State)

(Zip)

is/are conducting a ____________________________business in _________________, Nevada, under the fictitious

(Type of Business)

(City)

name of ______________________________________________________________________________________

(Fictitious Firm Name) or (Doing Business As)

and that said firm is composed of the following person(s) whose name(s) and address(es) are as follows:

(1) ______________________________________________

___________________________________________

Full Name and title (Type or Print)

Signature

Date

___________________________________________________________________________________________

Street Address of Business or Residence

City, State, Zip

_________________________________________________________________________________________________________________________________________________________

Mailing Address, if different from above

City, State, Zip

(2) ______________________________________________

___________________________________________

Full Name and title (Type or Print)

Signature

Date

___________________________________________________________________________________________

Street Address of Business or Residence

City, State, Zip

_________________________________________________________________________________________________________________________________________________________

Mailing Address, if different from above

City, State, Zip

(3) ______________________________________________

___________________________________________

Full Name and title (Type or Print)

Signature

Date

___________________________________________________________________________________________

Street Address of Business or Residence

City, State, Zip

_________________________________________________________________________________________________________________________________________________________

Mailing Address, if different from above

City, State, Zip

(For additional names or execution of additional notary signatures, please attach a separate sheet.)

Subscribed and sworn to before me this __________ day of

Certificate filed on ________20______Expires on____________20_____

______________________________________, 20________.

_________________________________________________

Certificate File Number _______________

Notary Public