FICTITIOUS OR ASSUMED NAME CERTIFICATE BY A CORPORATION CERTIFICATE
The following is hereby certified: 1. Business is, or will be, transacted at: , under the , a corporation incorporated under the laws of authorized to transact business in the State of name of (state), and , with its main office located at:
2. The nature of the business is: 3. The corporation is the sole owner of the business and no other corporation or entity is interested in the conduct of said business. This certificate is executed and filed pursuant to: Date: STATE OF COUNTY OF On ___________________________________
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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)
*NOTE: If you live in New York State, call the New York State Department of Corporation for the official form.