Certificate Of Persons Conducting Business Under Assumed Name Form printable pdf download

CERTIFICATE OF PERSONS

STATE OF MICHIGAN

CONDUCTING BUSINESS UNDER ASSUMED NAME

LIVINGSTON COUNTY CLERK

____________________

Filing Fee $10.00

This is a legal document. Please print clearly.

THE UNDERSIGNED hereby certifies, under the provisions of P.A. No. 111, P.A. of Michigan for the year 1990, as amended,

that the following person (or persons) now owns, carries on, conducts or transacts, or intends to own, carry on, conduct or

transact, a business, or maintain an office or place of business, in the County of___________________________, under the

name, designation or style set forth below:

Original

Renewal

Change of Location

Dissolution

Name Change (i.e., Legal, Marriage)

Individual

General Partnership

Fiduciary of Trust

Fiduciary of Will

Name of Business:______________________________________________________________________________________

Physical Address of Business:_____________________________________________________________________________

Street Address

City

Zip

Located in the (Choose One)

City of _____________________ Township of ____________________ Village of______________________

The undersigned further certifies that the true or real full name and residential address of the person(s) owning, conducting or

transacting said business is:

NAME

RESIDENTIAL ADDRESS

CITY

STATE

ZIP

SIGNATURES OF PERSONS CONDUCTING BUSINESS UNDER ASSUMED NAME

DATE OF SIGNING

__________________________________

_________________________________

__________________, 20___

__________________________________

_________________________________

Subscribed and sworn to before me this _______ day of ________________________, 20______A.D. by

STATE OF MICHIGAN

all persons listed above.

________________________________________________________________________, Notary Public

ACTING IN:_________________________ County, Michigan

My Commission Expires:_____________________

THIS CERTIFICATE EXPIRES FIVE YEARS FROM DATE OF FILING WITH COUNTY CLERK

(THIS PORTION TO BE COMPLETED BY COUNTY CLERK – DO NOT WRITE BELOW THIS LINE)

File Date:_____________________________ Expiration Date:____________________________

STATE OF MICHIGAN

COUNTY OF LIVINGSTON

I, _______________________________________, Clerk of the County aforesaid and Clerk of the Circuit Court for said County, do hereby certify that I have

compared the within copy of Certificate setting forth the full names of the persons owning, conducting or transacting business under the name of

__________________________________________________________________________ together with the certificate of filing endorsed thereof, with the

original Certificate heretofore filed and now remaining in my Office, and that it is a true and correct copy thereof, and of the whole of such original Certificate

and of said Certificate of Filing.

IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said Circuit Court, on this: ________________________________________

_____________________________________________________________ COUNTY CLERK

By:__________________________________________________, DEPUTY COUNTY CLERK

Mail this application, notarized with the $10.00 fee to: Livingston County Clerk, Assumed Names,

200 E. Grand River Ave., Howell, MI 48843

Telephone: (517) 546-8177

NOTE: This Certificate must be renewed within five (5) years from date of filing. If you change your place of business, you must notify this Office. If you

change the personnel listed above, you must file a Notice of Dissolution and a new Certificate with this Office. If you discontinue your business, you must file a

Notice of Dissolution with this Office. “Person” means 1 or more individuals, partnerships, trusts, fiduciaries, or other entities capable of contracting.

Certificate Of Persons Conducting Business Under Assumed Name Form

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