Form Aan - Amended Certificate Of Assumed Name
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1
2Kentucky Secretary of State
T
G
REY
RAYSON
_____________________________________________________________________________________________________________
Division of Corporations
Amended Certificate of
AAN
B
F
USINESS
ILINGS
Assumed Name
P.O. Box 718
Frankfort, KY 40602
(502) 564-2848
_____________________________________________________________________________________________________________
This certifies that the assumed name of:
_____________________________________________________________________________________________________________
[Name of record with the Secretary of State)]
has been amended to revise the real name of the partners or business organization holding the assumed name to:
____________
_________________________
________________________________________________________________________
[Real name – KRS 365.015(1)]
The certificate of assumed name was filed with the Secretary of State on: ______________________________
The current principal office address is:
______________________________________________________________________________________________________________
Street Address, if any
City
State
Zip Code
The principal office address is hereby changed to:
_________________________________________________________________________________________
Street Address, if any
City
State
Zip Code
The certificate is effective upon filing unless a delayed effective date and/or time is specified: _______________
The changes in the identity of the partners are as follows: ____________________________________________
__________________________________________________________________________________________
The amended certificate of assumed name is executed by:
_____________________________________________________
_____________________________________________________
)
)
(Signature
(Signature
_____________________________________________________
_____________________________________________________
)
(Type or Print Name
(Type or Print Name)
_______________________________________________
_______________________________________________
Date
Date
Instructions:
Submit this form with one (1) exact or conformed copy. The filing fee is $20.00. Please make your check payable to the
“Kentucky State Treasurer”.
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