ASSUMED NAME RECORDS
HUNT COUNTY TEXAS
STATEMENT
OF
ABANDONMENT
OF
USE
OF
A BUSINESS
OR
PROFESSIONAL
NAME
FOR
UNINCORPORATED
BUSINESS
OR
PROFESSION
1.
The Assumed Business
or
Professional Name being abandoned
is:----------------------
2. The Original Certificate Number on file is:
3. The date on which the Assumed Name
Certi:-:.fi:-Ic-a~te_w_a_s-:fi::d-ed
7
:-------------------------
4.
The Applicant's name
and
residence
or
office address as shown on
the
Assumed Name Certificate:
NAME
TITLE
______________
_
RESIDENCEORNVULINGADDRESS
____
=-=-=--=--~~~~~~~~------------------------=-----=-
(CITY,
STATE,
ZIP)
NAME
_________________
__
TfiLE
______________
_
RESIDENCE
OR
MAILING
ADDRESS
-----------:==-o--::=-:-==-::=-----------------
(CITY,
STATE,
ZIP)
NAME
__________________
__
TITLE
___________________________
__
RESIDENCE
OR
MAILING
ADDRESS
_________
-==:--:::=-:-=-==-------------------
(CITY,
STATE,
ZIP)
*************************************************************************************************************************************
WARNING:
INTENTIONALLY PROVIDING FALSE
OR
FRAUDULENT INFORMATION
ON
THIS APPLICATION IS A VIOLATION OF THE LAW AND
MAY
RESULT IN IMPRISONMENT
OF
NOT
MORE THAN 5 YEARS AND/OR FINE OF UP TO $10,000 (fX. Business & Commerce Code §71.203; TX. Penal
Code§
37.10). By signing below, the applicant(s) acknowledge understanding
of
and compliance with the statutes cited.
*************************************************************************************************************************************
Printed Name
of
Owner Signature
of
Owner
Printed Name
of
Owner Signature
of
Owner
Printed Name
of
Owner Signature
of
Owner
THE
STATE
OF
________
_
COUNTY
OF
__________________
_
BEFORE ME, THE UNDERSIGNED AUTHORITY, on this day personally appeared
Before me, the undersigned authority,
on
this day personally appeared , known to me
or
proved to me through to be the person whose name is subscribed to the foregoing
instrument and acknowledged to me that he/she/they executed the same for the purposes and consideration therein expressed.
GIVEN UNDER
MY
HAND AND SEAL OF OFFICE,
on
_____________________________
_,
20
_____
--'
Notary/County Clerk/Deputy County Clerk Signature
(Seal below)
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