AFFIDAVIT OF PUBLICATION OF CERTIFICATE–FICTITIOUS OR ASSUMED NAME by dnkume22

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									                AFFIDAVIT OF PUBLICATION OF CERTIFICATE–
                      FICTITIOUS OR ASSUMED NAME

STATE OF
COUNTY OF                      }
                                      , affiant, of                                        , City of
                               , County of                            , State of                    ,
being duly sworn on oath, deposes and says:
         1. Affiant is or was the                             of                                    ,
a daily newspaper of general circulation, printed, published, and circulated in the City of
                        , County of                           , State of                      .
         2. The original or renewal                        name certificate, a true copy of which is
attached hereto and marked as Exhibit A, was published in said newspaper once a                   for
                successive             , on the following dates:



and the publication was made in the newspaper proper and not in a supplement.


Dated:                                                ___________________________________



On                              before me,                                    , personally appeared
                                                                      , personally known to me (or
proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same
in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument
the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.

Signature___________________________
                                                         Affiant _____Known _____Unknown
                                                         ID Produced________________________
                                                                                       (Seal)




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