Free Registration of Trade Name - Wyoming

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

Application for Registration of Trade Name
1. Trade name to be registered:

2. Name of applicant:

3. Business address of applicant:

4. Mailing address of the trade name:

5. Applicant is (check one): individual; limited partnership; unincorporated association; corporation; limited liability company; other: general partnership; statutory trust;

6. If the applicant is a corporation, limited partnership, limited liability company or statutory trust, list the state of incorporation or organization: If a limited partnership, general partnership, or statutory trust, list the names and addresses of the partners, general partners, or trustees:

If other, explain:

7. Describe general nature of business conducted by applicant:

8. Date first used in Wyoming:
(Date ­ mm/dd/yyyy)

·The name must be in use in Wyoming prior to registration.

Date:
(mm/dd/yyyy)

Signature: ___________________________________________ Print Name: Title:

Contact Person: Daytime Phone Number:

State of ____________________) County of __________________) The foregoing instrument was acknowledged before me by _______________________________________________ this ______________________ day of _______________________________________________, ______________.

Witness my hand and official seal. (Notarial Seal) _______________________________________ Notary Public

My commission expires: _______________________

Checklist Filing Fee: $100.00 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-RegistrationApplication - Revised 12/2008