Form Bus41 - Certificate Of Assumed Name Renewal (2003) Page 2
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1
2DIRECTIONS
PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK.
1. If this is a pre-printed form, the information on the left reflects the current information on file with our
office. If the information has changed, please fill in the current information in the box to the right of the
item you are changing.
2. If this is not a pre-printed form, list the current information on file with the Secretary of State’s Office,
make any changes in the box to the right of the item you are changing.
3. If any changes are made to item #5, please remember to fill in the name and full street address of all
persons conducting business under this assumed name. Note: If the business owner is a corporation or
other business entity you must give the legal business name and the legal registered office address or
principal place of business, whichever is applicable.
4. The form must be signed by one of the most current nameholder(s).
5. State the name and telephone number of a person who can be contacted about the form.
6. If the right side of the form has been filled in, you must publish the changes, after filing, in the legal
notices section of a qualified legal newspaper for two consecutive issues in the county where the business
has its principal or registered office. The newspaper will return an affidavit of publication and the
newspaper ad which should be retained by the assumed name holder with the Certificate of Assumed
Name. The affidavit does not need to be sent to our office. Failure to publish the changes may render
them invalid.
7. The penalty for doing business without filing this renewal is a $250 fee payable to any opposing party in
any legal contest.
8. The filing fee is $25. Make checks payable to the Secretary of State.
Return the renewal form and fee to:
Minnesota Secretary of State
Business Services Division
180 State Office Building
100 Rev. Dr. Martin Luther King Jr. Blvd.
St. Paul, MN 55155-1299
This document can be made available in alternative formats, such as large print, Braille or audio tape, by
calling (651)296-2803/Voice, or on our Web site at For TTY communication, contact
the Minnesota Relay Service at 1-800-627-3529 and ask them to place a call to (651)296-2803. The Secretary
of State's Office does not discriminate on the basis of race, creed, color, sex, sexual orientation, national
origin, age, marital status, disability, religion, reliance on public assistance or political opinions or affiliations
in employment or the provision of services.
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