Town of Vernon
CANCELS
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Office of the Town Clerk
14 Park Place
Vernon, Connecticut 06066
(860) 870-3662
CANCELLATION OF TRADE NAME
[ I am / We are ] no longer conducting and transacting business in said Town of Vernon,
Connecticut, under the full name of ______________________________________________
TYPE OF BUSINESS: ________________________________________________________
BUSINESS ADDRESS: _______________________________________________________
The full name of every person conducting or transacting said business, together with the
post office address of each said person is as follows:
c Name____________________________ Mailing Address _________________________
_________________________
d Name____________________________ Mailing Address _________________________
_________________________
e Name____________________________ Mailing Address _________________________
_________________________
STATE OF CONNECTICUT : ___________________________
ss. Vernon _________________, 200___ ___________________________
COUNTY OF TOLLAND : ___________________________
signature
Personally appeared _________________________________________________________
__________________________________________________________________________
who subscribed and swore to the truth of the foregoing certificate, and acknowledged that
_________________________________________________ executed the same, before me.
___________________________
Town Clerk (Asst.) – Notary Public
Received and Filed _____________________ @ _______________
_______________________________________________________
Town Clerk (Asst.)