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Richmond Trade Name Registration

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					                             RICHMOND COUNTY SUPERIOR COURT
                                 TRADE NAME REGISTRATION


            PERSONALLY APPEARED THE UNDERSIGNED WHO ON OATH DEPOSES AND SAYS
THAT:

*
(name of proprietor or corporate name if corporation)

*
(address of proprietor or parent corporation)

and
*
(name of second proprietor or corporation if any)

*
(address)


                           TRADENAME:*

                                           *
                                               (tradename address in Richmond County)

and that the nature of the business to be carried on at such address is

*


                                           *
                                               (signature of person making declaration)


SWORN TO AND SUBSCRIBED BEFORE
ME THIS          DAY OF                                             , 20          .


NOTARY PUBLIC
                                                  FEES: $157.00 Filing Fee to Clerk of Superior Court
                                                        $40.00 Publication Fee to The Augusta Chronicle


RECORDED:
  BOOK:                   PAGE:
                                                                            DEPUTY CLERK

				
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