Free Consent to Use of Name.pdf - Minnesota


File Size: 63.2 kB
Pages: 2
Date: May 18, 2007
File Format: PDF
State: Minnesota
Category: Secretary of State
Author: Lan Administrator
Word Count: 1,040 Words, 7,070 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.sos.state.mn.us/docs/consent.pdf

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STATE OF MINNESOTA SECRETARY OF STATE CONSENT TO THE USE OF A NAME
PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK.

For your convenience, this form has been designed to be completed online. You must have Acrobat Reader 5.0 or above to use this new feature. Once your form is completed, be sure to select "Print" at the bottom of the screen to capture your data entry for printing. After printing, sign and send applicable fees as required.Note: Selecting "Reset" will clear all data entry from this page. To print a blank form, go to File->Print.

Please complete this side if this office has a name already on file that is similar to the name you wish to register. If you are unable to locate the holder of the name already on file, see the reverse side of this form. Submit this form to the office along with the original filing or amendment you wish to record. 1. Name You Wish to Register: _________________________________________________________________________ 2. Name Already on File:______________________________________________________________________________ Address: ___________________________________________________________________________________________ (street) (city) (state) (zip) PLEASE HAVE THIS PORTION COMPLETED BY THE HOLDER OF THE NAME ALREADY ON FILE: I grant consent to register the name listed on line 1 to: ________________________________________________________ (list name of person or entity registering new name) located at ___________________________________________________________________________________________ (street) (city) (state) (zip) (Check one) ____ unconditionally. ____ with the following conditions:* __________________________________________________________ ______________________________________________________________________________________ *NOTE: Conditions must be privately enforced. I certify that I am authorized to sign this consent and I further certify that I understand that by signing this consent I am subject to the penalties of perjury as set forth in section 609.48 as if I had signed this consent under oath. Signed: ____________________________________________________________ Position: __________________________Daytime Phone:_____________________

INSTRUCTIONS
1. Complete one form for each name already on file. 2. Filing fee: $35.00 per form, payable to the MN Secretary of State. FILE IN-PERSON OR MAIL TO: Minnesota Secretary of State - Business Services Retirement Systems of Minnesota Building 60 Empire Drive, Suite 100 St Paul, MN 55103 (Staffed 8:00 - 4:00, Monday - Friday, excluding holidays)

Print only this page

Reset

All of the information on this form is public. Minnesota law requires certain information to be provided for this type of filing. If that information is not included, your document may be returned unfiled. This document can be made available in alternative formats, such as large print, Braille or audio tape, by calling (651)296-2803/voice. For a TTY/TTD (deaf and hard of hearing) communication, contact the Minnesota Relay Service at 1-800-627-3529 and ask them to place a call to (651)296-2803. The Secretary of State's Office does not discriminate on the basis of race, creed, color, sex, sexual orientation, national origin, age, marital status, disability, religion, reliance on public assistance or political opinions or affiliations in employment or the provision of service.
bus6 Consent Rev. 05-07

MINNESOTA SECRETARY OF STATE AFFIDAVIT FOR THE REGISTRATION OF A NAME
PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK.

For your convenience, this form has been designed to be completed online. You must have Acrobat Reader 5.0 or above to use this new feature. Once your form is completed, be sure to select "Print" at the bottom of the screen to capture your data entry for printing. After printing, sign and send applicable fees as required.Note: Selecting "Reset" will clear all data entry from this page. To print a blank form, go to File->Print.

Instructions: Complete this side if you are unable to locate the holder of a name already on file to obtain consent to register a name. You may be able to register the name by fulfilling ALL of the requirements listed below. 1. Name You Wish to Register: __________________________________________________________________________ 2. Name Already on File: _______________________________________________________________________________ Address: ____________________________________________________________________________________________ (street) (city) (state) (zip) I hereby certify that I have the right to register the desired name because I have fulfilled ALL of the requirements of Minnesota Statutes listed below: A. I have determined that the entity or person holding the conflicting name has not filed any document under that name with the Office of the Secretary of State of Minnesota during the preceding three years. B. I have sent written notice to this entity or person at the last registered office or business address as listed with the Secretary of State, and that notice was sent by certified mail and has been returned as undeliverable. C. After diligent inquiry, I have been unable to find any telephone listing for that entity or person in the county in which that registered office or business address is located; and D. I have no personal knowledge that the entity or business is currently engaged in business in this state. I certify that I am authorized to sign this affidavit and I further certify that I understand that by signing this affidavit, I am subject to the penalties of perjury as set forth in section 609.48 as if I had signed this affidavit under oath. Name: __________________________________ Signed: _________________________________ Daytime Phone Number: ____________________ Position: ________________________________

INSTRUCTIONS
1. Complete one form for each name already on file. 2. Filing fee: $35.00 per form, payable to the MN Secretary of State. 3. Make check payable to the MN Secretary of State.

FILE IN-PERSON OR MAIL TO: Minnesota Secretary of State - Business Services Retirement Systems of Minnesota Building 60 Empire Drive, Suite 100 St Paul, MN 55103 (Staffed 8:00 - 4:00, Monday - Friday, excluding holidays)

Print only this page

Reset

All of the information on this form is public. Minnesota law requires certain information to be provided for this type of filing. If that information is not included, your document may be returned unfiled. This document can be made available in alternative formats, such as large print, Braille or audio tape, by calling (651)296-2803/voice. For a TTY/TTD (deaf and hard of hearing) communication, contact the Minnesota Relay Service at 1-800-627-3529 and ask them to place a call to (651)296-2803. The Secretary of State's Office does not discriminate on the basis of race, creed, color, sex, sexual orientation, national origin, age, marital status, disability, religion, reliance on public assistance or political opinions or affiliations in employment or the provision of service.
bus6 Consent Rev. 05-07