Fillable CERTIFICATE OF ASSUMED BUSINESS NAME (Posey County)

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CERTIFICATE OF ASSUMED BUSINESS NAME (Posey County)

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U.S.A. forms for Posey County

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CERTIFICATE OF ASSUMED BUSINESS NAME
for persons (sole proprietorships, associations, or general partnerships)
engagedinbusinessunderanameotherthantheirown(DBA)
Name of Business_______________________________________________________
Kind of Business_______________________________________________________
Address of Business___________________________________________________
NAMES&RESIDENCESOFMEMBERSOFBUSINESS:
_______________________________Resides at______________________________
_______________________________Resides at ______________________________
_______________________________Resides at ______________________________
___________________________________________
Signature of Member
___________________________________________
Print Member’s Name
STATE OF _____________
SS:
COUNTY OF ____________
I hereby acknowledge _______________________________, personally appeared before me a
Notary Public, this ____day of ____________,20____.
My Commission Expires __________________
County of Residence_____________________
___________________________
Notary Public – Signature
___________________________
Notary Public - Printed Name
I affirm, under the penalties for perjury, that I have taken reasonable care to redact each Social Security number in
this document, unless required by law:________________________________Print Name
This instrument was prepared by:_________________________________________________
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CERTIFICATE OF ASSUMED BUSINESS NAME (Posey County)

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Completed 18 July 2020

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