AFFIDAVIT OF PUBLICATION OF CERTIFICATE–
FICTITIOUS OR ASSUMED NAME
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.
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.
Affiant _____Known _____Unknown