Please complete this form if the business name you wish to register is already registered with this office by another. If
you are unable to locate the holder of the name already on file, you may be able to file an Abandoned Name Affidavit.
Submit this form along with the original filing or amendment you wish to record. Complete one form for each
name already on file.
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 you wish to register. (Required)
2. List the business name on file with this office that is in conflict with the name y
ou are filing. (Required)
3. List the address of the business on file with this office. (Required)
4. The next section must be completed by the holder of the name that is already on file with this office. (Required)
5. Signature of authorized representative or agent (The 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 authorized to sign
on behalf of that person(s).)
List a name and daytime telephone number of a person who can be contacted about this form.
Filing Fee: $55 for expedited service in-person, $35 if submitted by mail
Payable to the MN Secretary of State
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.