Form 08-575 - Business Name Registration/renewal Application
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1BUSINESS NAME REGISTRATION/RENEWAL APPLICATION
Provide all information. Please type or print, except for the signature.
Initial registration
Business Name to Register
Renewal
Full business name:
Owner Name and Address
Name:
Address:
City, state, postal code:
Use the principal office address for a corporation DBA.
Addresses of Business
Address:
Address:
Attach a continuation sheet, if needed.
Persons with Ownership Interest
Name:
Address:
City, state, postal code:
Attach a continuation sheet, if needed.
For a corporation DBA, see the following:
The list of 5% or more shareholders and alien affiliates filed with our most recent biennial report is complete and correct.
Statement of Business
This business is in operation. The nature of the business is:
Signed:
STATE USE ONLY
Printed name:
Date received
Title:
Check #
Signer must be: an owner of the business; president or vice-president of
Dollar amount
the corporation; the general partner of the limited partnership; a member of
the limited liability company; a general partner of the limited liability
Cash
partnership.
Card type
Return form and $25.00 payment to
Authorization #
Dept. of Community and Economic Development
Corporations Section
Registration #
PO Box 110808
Juneau AK 99811-0808
Registration Date
Expiration Date
The application will not be accepted unless the fee
is enclosed, payable to the State of Alaska.
08-575
Revised 4/2001
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Parent category: Legal