STATE OF SOUTH CAROLINA
SECRETARY OF STATE
ADOPTION OF A FICTITIOUS NAME
Corporation - Foreign
TYPE OR PRINT CLEARLY IN BLACK INK
Pursuant to S.C. Code of Laws §33-15-106, the undersigned submits the following:
1. Applicant’s Name (individual submitting form) _________________________________________________
2. The legal name of the corporation is _________________________________________________________
(Must match corporation name on certificate from domestic state)
3. The date that the Board of Directors adopted the resolution to use the fictitious name __________________
4. Enter the Fictitious Name that the Board of Directors adopted to use for conducting business in the state of
South Carolina __________________________________________________________________________
(The fictitious name must have a corporate ending)
5. By signing and submitting this form you are affirming that the Board of Directors of the corporation duly
adopted the resolution to use a fictitious name in South Carolina for conducting all business at a duly called
meeting of the Board. A quorum was present for the meeting and the resolution was set forth in the minutes
of the meeting. Additionally, you are affirming that you are the keeper of the corporate seal and of the minutes
and records of the corporation and the said resolution has not been rescinded or modified.
Date ________________________
________________________________
Signature of Officer
________________________________
Type or Print Name
________________________________
Position of Officer
FILING INSTRUCTIONS
1.
Two copies of this form must be submitted for filing.
2.
$10.00 filing fee made payable to the South Carolina Secretary of State.
3.
Self-addressed stamped return envelope.
4.
Return to:
Secretary of State
Attn: Corporations
1205 Pendleton St., Ste. 525
Columbia, SC 29201
Form Revised by South Carolina Secretary of State, March 2012