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Free Fillable Certificate of Assumed Name Form - New York



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Excerpt: NYS Department of State Certificate of Assumed Name Pursuant to General Business Law, 130 1. NAME OF ENTITY Division of Corporations, State Records and UCC One Commerce Plaza, 99 Washington Ave, Albany, NY 12231-0001 www.dos.state.ny.us 1a. FOREIGN ENTITIES ONLY. If applicable, the fictitious name the entity agreed to use in New York State is: 2. NEW YORK LAW FORMED OR AUTHORIZED UNDER (CHECK ONE): Business Corporation Law Education Law Insurance Law Other (specify law): 3. ASSUMED NAME Limited Liability Company Law Not-for-Profit Corporation Law Revised Limited Partnership Act 4. PRINCIPAL PLACE OF BUSINESS IN NEW YORK STATE (MUST BE NUMBER AND STREET. IF NONE, INSERT OUT-OF-STATE ADDRESS) 5. COUNTIES IN WHICH BUSINESS WILL BE CONDUCTED UNDER ASSUMED NAME ALL COUNTIES (if not, circle county[ies] below) Albany Allegany Bronx Broome C
NYS Department of State

Certificate of Assumed Name
Pursuant to General Business Law, 130
1. NAME OF ENTITY

Division of Corporations, State Records and UCC One Commerce Plaza, 99 Washington Ave, Albany, NY 12231-0001 www.dos.state.ny.us

1a. FOREIGN ENTITIES ONLY. If applicable, the fictitious name the entity agreed to use in New York State is:

2. NEW YORK LAW FORMED OR AUTHORIZED UNDER (CHECK ONE):

Business Corporation Law Education Law Insurance Law Other (specify law):
3. ASSUMED NAME

Limited Liability Company Law Not-for-Profit Corporation Law Revised Limited Partnership Act

4. PRINCIPAL PLACE OF BUSINESS IN NEW YORK STATE (MUST BE NUMBER AND STREET. IF NONE, INSERT OUT-OF-STATE ADDRESS)

5. COUNTIES IN WHICH BUSINESS WILL BE CONDUCTED UNDER ASSUMED NAME

ALL COUNTIES (if not, circle county[ies] below)
Albany Allegany Bronx Broome Cattaraugus Cayuga Chautauqua Chemung Chenango Clinton Columbia Cortland Delaware Dutchess Erie Essex Franklin Fulton Genesee Greene Hamilton Herkimer Jefferson Kings Lewis Livingston Madison Monroe Montgomery Nassau New York Niagara Oneida Onondaga Ontario Orange Orleans Oswego Otsego Putnam Queens Rensselaer Richmond Rockland St. Lawrence Saratoga Schenectady Schoharie Schuyler Seneca Steuben Suffolk Sullivan Tioga Tompkins Ulster Warren Washington Wayne Westchester Wyoming Yates

6. INSERT THE ADDRESS OF EACH LOCATION WHERE BUSINESS WILL BE CARRIED ON OR TRANSACTED UNDER THE ASSUMED NAME. Use a continuous sheet, if needed. (The address must be set forth in terms of a number and street, city, state and zip code. Please note that the address(es) reflected in paragraph 6 must be within the county(ies) circled in paragraph 5. If the entity does not have a specific location where it will conduct business under the assumed name please check the statement below.)

No New York State Business Location

DOS-1338 (Rev. 4/08)

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INSTRUCTIONS FOR SIGNATURE: If corporation, by an officer; if limited partnership, by a general partner; if limited liability company, by a member or manager or by an authorized person or attorney-in-fact for such corporation, limited partnership, or limited liability company. If the certificate is signed by an attorney-in-fact, include the name and title of the person for whom the attorney-in-fact is acting. (Example, John Smith, attorney-in-fact for Robert Johnson, president.)

Name of Signer

Signature

Title of Signer

CERTIFICATE OF ASSUMED NAME OF
(Insert Entity Name)

Pursuant to 130, General Business Law

FILER'S NAME AND MAILING ADDRESS

NOTE: This form was prepared by the New York State Department of State. You are not required to use this form. You may draft your own form or use forms available at legal stationery stores. The Department of State recommends that all documents be prepared under the guidance of an attorney. The certificate must be submitted with a $25 fee. The Department of State also collects the following, additional, county clerk fees for each county in which a corporation does or transacts business: $100 for each county within New York City (Bronx, Kings, New York, Queens and Richmond) and $25 for each county outside New York City. All checks over $500 must be certified.
(For office use only)

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File Size: 440.9 kB
Pages: 2
Date: May 30, 2008
File Format: PDF
State: New York
Category: Corporations
Word Count: 501 Words, 3,243 Characters
Page Size: Letter (8 1/2" x 11")
Embed
URL

http://www.dos.state.ny.us/corp/pdfs/dos1338.pdf