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1 Title 4 - Business and Commerce Code NUMBER OF YEARS THIS BUSINESS NAME WILL BE USED Not to exceed 10 years YEARS NAME IN WHICH BUSINESS WILL BE CONDUCTED BUSINESS ADDRESS CITY STATE ZIP BUSINESS TO BE CONDUCTED AS SOLE PROPRIETORSHIP GENERAL PARTNERSHIP OTHER LIMITED PARTNERSHIPS LIMITED LIABILITY COMPANIES AND CORPORATIONS MUST BE FILED WITH THE SECRETARY OF STATE - IF BUSINESS WILL BE IDENTIFIED BY A NAME OTHER THAN THE NAME ON FILE WITH THE SECRETARY OF STATE AN ASSUMED NAME CERTIFICATE MUST BE FILED WITH THE SECRETARY OF STATE AND IN EACH COUNTY IN WHICH THE BUSINESS WILL HAVE A REGISTERED OR PRINCIPAL OFFICE. I/WE THE UNDERSIGNED ARE THE OWNER S OF THE ABOVE BUSINESS AND MY/OUR NAME S AND ADDRESS GIVEN IS/ARE TRUE AND CORRECT AND THERE IS/ARE NO OWNERSHIP S IN SAID BUSINESS OTHER THAN LISTED BELOW. NAME SIGNATURE ADDRESS CITY STATE ZIP residence STATE OF TEXAS COUNTY OF ANGELINA BEFORE ME THE UNDERSIGNED AUTHORITY ON THIS DAY PERSONALLY APPEARED KNOWN TO ME TO BE THE PERSON S WHOSE NAME S IS/ARE SUBSCRIBED TO THE FOREGOING INSTRUMENT AND ACKNOWLEDGED TO ME THAT HE/SHE/THEY SIGNED THE SAME FOR THE PURPOSE AND CONSIDERATION THEREIN EXPRESSED. GIVEN UNDER MY HAND AND SEAL OF OFFICE THIS DAY OF 20. SIGNATURE OF NOTARY Notary Public in and for the State of Texas Commission Expires PLACE NOTARY SEAL BELOW THIS AREA FOR CLERK S USE ONLY. ASSUMED NAME CERTIFICATE FILING FEE - 14. 00. 50 - EACH ADDITIONAL SIGNATURE AS OWNER CERTIFICATE OF OWNERSHIP FOR UNINCORPORATED BUSINESS OR PROFESSION NOTICE CERTIFICATES OF OWNERSHIP ARE VALID ONLY FOR A PERIOD NOT TO EXCEED 10 YEARS FROM THE DATE FILED IN THE COUNTY CLERK S OFFICE Chapter 36 Sect. 1 Title 4 - Business and Commerce Code NUMBER OF YEARS THIS BUSINESS NAME WILL BE USED Not to exceed 10 years YEARS NAME IN WHICH BUSINESS WILL BE CONDUCTED BUSINESS ADDRESS CITY STATE ZIP BUSINESS TO BE CONDUCTED AS SOLE PROPRIETORSHIP GENERAL PARTNERSHIP OTHER LIMITED PARTNERSHIPS LIMITED LIABILITY COMPANIES AND CORPORATIONS MUST BE FILED WITH THE SECRETARY OF STATE - IF BUSINESS WILL BE IDENTIFIED BY A NAME OTHER THAN THE NAME ON FILE WITH THE SECRETARY OF STATE AN ASSUMED NAME CERTIFICATE MUST BE FILED WITH THE SECRETARY OF STATE AND IN EACH COUNTY IN WHICH THE BUSINESS WILL HAVE A REGISTERED OR PRINCIPAL OFFICE. I/WE THE UNDERSIGNED ARE THE OWNER S OF THE ABOVE BUSINESS AND MY/OUR NAME S AND ADDRESS GIVEN IS/ARE TRUE AND CORRECT AND THERE IS/ARE NO OWNERSHIP S IN SAID BUSINESS OTHER THAN LISTED BELOW. NAME SIGNATURE ADDRESS CITY STATE ZIP residence STATE OF TEXAS COUNTY OF ANGELINA BEFORE ME THE UNDERSIGNED AUTHORITY ON THIS DAY PERSONALLY APPEARED KNOWN TO ME TO BE THE PERSON S WHOSE NAME S IS/ARE SUBSCRIBED TO THE FOREGOING INSTRUMENT AND ACKNOWLEDGED TO ME THAT HE/SHE/THEY SIGNED THE SAME FOR THE PURPOSE AND CONSIDERATION THEREIN EXPRESSED. ASSUMED NAME CERTIFICATE FILING FEE - 14. 00. 50 - EACH ADDITIONAL SIGNATURE AS OWNER CERTIFICATE OF OWNERSHIP FOR UNINCORPORATED BUSINESS OR PROFESSION NOTICE CERTIFICATES OF OWNERSHIP ARE VALID ONLY FOR A PERIOD NOT TO EXCEED 10 YEARS FROM THE DATE FILED IN THE COUNTY CLERK S OFFICE Chapter 36 Sect. .

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