File your business document online by visiting our website at www.sos.state.mn.us.
This form is intended merely as a guide for filing and is not intended to cover all situations. Retain the original
signed copy of this document for your records and submit a legible photocopy for filing with the Office of the
Secretary of State.
1. List the business name of file with the Office of the Secretary of State. (Required)
2. List the original Certificate of Assumed Name number.
3. List the date on which the original was filed.
All current nameholders or an Authorized Agent (T
he signing party must indicate on the document that they
are acting as the agent of the person(s) whose signature would be required and that they have been
to sign on behalf of that p
erson(s).) must sign this cancellation form
Address for Official Notices. This email address may be used to send annual renewal reminders and other
important notices that may require action or response. Check the box if you wish to have your email address excluded
from requests for bulk data, to the extent allowed by Minnesota law.
List a name and daytime telephone number of a person who can be contacted about this form.
There is no fee for cancelling an Assumed Name.
Please submit all items together and mail to the address below:
FILE IN-PERSON OR MAIL TO:
Minnesota Secretary of State - Business Services
Retirement Systems of Minnesota Building
60 Empire Drive, Suite 100
St Paul, MN 55103
(Staffed 8 a.m. – 4 p.m., Monday - Friday, excluding holidays)
Phone Lines: (9 a.m. - 4 p.m., M-F) Metro Area 651-296-2803; Greater MN 1-877-551-6767
All of the information on this form is public. Minnesota law requires certain information to be provided for this type
of filing. If that information is not included, your document may be returned unfiled. This document can be made
available in alternative formats, such as large print, Braille or audio tape, by calling (651)296-2803/voice. For a
TTY/TTD (deaf and hard of hearing) communication, contact the Minnesota Relay Service at 1-800-627-3529 and
ask them to place a call to (651)296-2803. The Secretary of State's Office does not discriminate on the basis of race,
creed, color, sex, sexual orientation, national origin, age, marital status, disability, religion, reliance on public
assistance or political opinions or affiliations in employment or the provision of service.