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BUSINESS REGISTRATION CERTIFICATE PERSON CONDUCTING BUSINESS UNDER ASSUMED
NAME, OR PARTNERSHIP
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D.B.A.
File No. ______________ Certificate
Exp. ______________ Certificate
Filed ______________ Dissolved
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THE UNDERSIGNED hereby
certifies, under the provisions of P.A. No. 101, P.A. of Mich., for the year
1907, as amended, that the following person (or persons) now owns, carries
on, conducts or transacts, or intends to own, carry on, conduct, or transact,
a business, or maintain an office or place of business, in the County of
Lapeer, State of Michigan, under the name, designation or style set forth
below: |
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FILING FEE $10.00 |
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1. |
Name
of Business _____________________________________________________________________________________ Address
of Business
___________________________________________________________________________________ Mailing
Address if different
Township ____________________________________________________________________ | |||||||||||
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2. |
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INDIVIDUAL 3. NAME OF PERSON OR
PERSONS, owning, conducting, transacting, or composing the above business,
and the home post office address of each. |
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NAME OF PERSON |
RESIDENCE ADDRESS
(Street, City, State) |
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(Print) |
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(Print) |
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(Print) |
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(Print) |
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GENERAL 4. PARTNERSHIP CERTIFICATE. The Undersigned hereby certify under the
provisions of P.A. No. 164, P.A. of Mich. for the year 1913, as amended, that: (a) The Business mentioned herein (Insert "IS" or "IS NOT")
(If the Business IS a Partnership, fill in the Blank line under (b)
below.) (b) Length of Time General Partnership is to
Continue. (Insert either the Term agreed on by the Partners, or the statement "not limited". |
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5. SIGNATURES OF ALL PERSONS LISTED ABOVE - Acknowledged before
a Notary Public. |
(Signature) |
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(Signature) |
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(Signature) |
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(Signature) |
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STATE
OF |
Subscribed
and sworn to before me this __________________ day of _____________________________,
20_________ by all the persons listed above. |
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(Signature) |
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(Print) |
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Notary Public,
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My
Commission Expires: |
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(Form
below for use of |
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STATE
OF |
I, Marlene M. Bruns,
Clerk of the County of Lapeer and the Circuit Court thereof, do hereby
certify that I have compared the foregoing copy of Business Registration Certificate
with the original of record in my office, and that the same is a correct
transcript therefrom, and of the whole of such original. IN TESTIMONY WHEREOF, I
have hereunto set my hand and affixed the seal of said Circuit Court, at the
City of Marlene M. Bruns, Lapeer
COUNTY/CLERK/DEPUTY
COUNTY CLERK |
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