Farm/Ranch/Home Registration Apr2018
Secretary of State Office
500 E Capitol Ave
Pierre, SD 57501
(605)773-3537
trademark@state.sd.us
1. Applicant:
Address: City: State: Zip:
2. Name of Farm, Ranch, or Home:
3. Location of (Directions to) Farm, Ranch, or Home Headquarters:
4. List each County where the Farm, Ranch or Home owns property:
5. List the legal description in Each County where the Farm, Ranch or Home owns property (You may attach additional pages
if necessary):
*** This section is to be completed in the presence of a Notary Public ***
State of )
)§§
County of )
I, , _________________________________________
Printed Name of Authorized Person Title
of
Name of Business as Applicant
do solemnly swear that the above-named applicant is the owner/representative of the above-named entity and that no other
person has the right to use such name in the indicated county in the State of South Dakota either in the identical form
thereof or in such near resemblance thereto as might be calculated to deceive or to be mistaken therefor.
Dated
Signature of authorized person
Subscribed and sworn to before me this _______ day of________________________, 20 _______.
Notary Public Signature
(Notarial Seal)
My Commission Expires
Name of Farm, Ranch, and Home
Registration Application
SDCL 43-27-1
FILING FEE: $15
Make Check payable to SECRETARY OF STATE
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signature
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signature
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