SFN 53850 (06-2006) Page 3
INSTRUCTIONS FOR TRADE NAME ASSIGNMENT (continued)
FAX FILING: The document and Credit Card Payment Authorization may be faxed to 701-328-2992. A faxed filing does not expedite the process of the
application in the office of the Secretary of State.
EMAIL: Email is not a secure utility for the transmission of private information or credit card authorizations. DO NOT EMAIL YOUR DOCUMENT TO THE
SECRETARY OF STATE.
MAILING INSTRUCTIONS: Send the signed assignment form and $25.00 to:
Secretary of State
State of North Dakota
600 E Boulevard Ave Dept 108
Bismarck ND 58505-0500
Telephone: 701-328-4284
Toll Free: 800-352-0867 (8-4284)
Fax: 701-328-2992 Home Page:
RENEWALS: Every trade name certificate filed with the Secretary of State must be renewed every five years from the date of the initial filing. Forms for
renewal are prescribed by the Secretary of State and will be sent to the address of the principal place of business of the owner at least ninety days before
the deadline for filing. To insure delivery of a renewal notice it is imperative that the owner's principal place of business address be maintained current with
the Secretary of State.
CANCELLATION: If anyone fails to file the renewal when due, the Secretary of State shall cancel the trade name registration. The registration will also be
canceled by the Secretary of State when the registrant is a corporation, limited liability company, limited partnership, limited liability partnership, or limited
liability limited partnership that has failed to file an assigment and has ceased to exist for six months.
CREDIT CARD PAYMENT AUTHORIZATION
SECRETARY OF STATE
SFN 51478 (06-03)
(All items required to complete transaction)
Name:
Address:
City:
State:
Zip Code:
Signature: (Required by credit card companies)
Discover
VISA
Master Card
V #
Account Number:
Card Expires:
Month
Year
Date:
-