Application For Registration Of Trade Name Form
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1Office Use_____________
Approved by:_____________
Please mail registration to:
Betsey Bayless
Secretary of State
Trade Name Division
1700 West Washington 7th Floor
Phoenix, Arizona 85007
602/542-6187
Filing Fee: $10.00
APPLICATION FOR REGISTRATION OF TRADE NAME
(A.R.S. §44-1460)
The Registration of Trade Names and Trademarks is not legally required in Arizona, but is an accepted
business practice. This is a registration for an Arizona Trade Name only in accordance with A.R.S. §44-
1460. This certificate does not in any way constitute the registration of an Internet Domain Name. Please
note we do not register corporation names (e.g., ABC Inc.). Please clearly print or type your application
to avoid registration errors.
Name, title or designation to be registered:
Name of Applicant(s):
Your certificate and renewal notices are dependent on accurate address information including suite
numbers. Remember to update your registration if you move.
Business Address:
Street or Box Number
City
State
Zip
Phone (Optional):
Applicant must check one. Do not select “Corporation” or
“LLC” if you are not currently
incorporated, or your application will be returned to you.
Person
Firm
Arizona Corporation
LLC
Foreign Corporation licensed to do business in Arizona
Partnership
Association
Society
Organization
The date in which the name, title or designation was first used by the applicant within this state. This date
must be today’s date or prior to today’s date:
Month
Day
Year
General nature of business conducted:
Applicant’s Printed Name
Applicant’s Signature
State of
County of
Acknowledged before me on this
day of
,
Notary Public
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