REGISTRATION OF ASSUMED BUSINESS NAME
STATE OF LOUISIANA
PARISH OF __________________________________________________________________
BEFORE ME, THE UNDERSIGNED AUTHORITY, PERSONALLY CAME AND
APPEARED____________________________________________________ WHO AFTER
BEING BY ME FIRST DULY SWORN DID DEPOSE AND SAY:
THAT THEY ARE OPERATING A BUSINESS UNDER THE ASSUMED NAME
OF __________________________________________________________AND THAT THE
ADDRESS OF AFFIANTS IS
______________________________________________________________________________
______________________________________________________________________________
______________________________
Signee
______________________________
Signee
SWORN TO AND SUBSCRIBED BEFORE ME THIS
______ day of_____________________________, 20___
______________________________
NOTARY PUBLIC