Form 504 - Abandonment Of Assumed Name Certificate - Secretary Of State Texas Page 4
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47b. The address of the entity’s principal place of business in Texas (if not the same as 7a) is:
7c. The entity is not organized under the laws of Texas. Its office address outside the state is:
County or Counties in which Assumed Name Filed
8. The assumed name being abandoned was filed on the following dates in the following counties:
Name of County
Date of Filing
Name of County
Date of Filing
Execution
The undersigned signs this document subject to the penalties imposed by law for the submission of a
materially false or fraudulent instrument and also certifies that the person is authorized to sign on
behalf of the identified entity. If the undersigned is acting in the capacity of an attorney in fact for the
entity, the undersigned certifies that the entity has duly authorized the undersigned in writing to
execute this document.
Date:
Signature of a person authorized by law to sign on behalf of the
identified entity (see instructions)
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