Wyoming Secretary of State
State Capitol Building, Room 110 200 West 24th Street Cheyenne, WY 82002-0020 Ph. 307.777.7311 Fax 307.777.5339 Email: [email protected]
For Office Use Only
Cancellation of Trade Name
1. I,
(Name of registrant)
2. Registrant of the trade name:
3. Trade name was registered with the Secretary of State's Office on:
(Date mm/dd/yyyy)
2. I hereby cancel registration of this trade name.
Date:
(mm/dd/yyyy)
Registrant Signature: _________________________________ Print Name:
Contact Person: Daytime Phone Number: Checklist Filing Fee: $10.00 Make check or money order payable to Wyoming Secretary of State. Please submit one originally signed document and one exact photocopy of the filing. Please review form prior to submitting to the Secretary of State to ensure all areas have been completed to avoid a delay in the processing of your documents.
TN-Cancellation - Revised 12/2008