BUSINESS REGISTRATION CERTIFICATE

PERSON CONDUCTING BUSINESS UNDER ASSUMED NAME, OR PARTNERSHIP

 

County of Lapeer, Office of County Clerk

D.B.A. File No. ______________

Certificate Exp. ______________

Certificate Filed ______________

Dissolved ___________________

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:

FILING FEE $10.00

 

1.

 

Name of Business _____________________________________________________________________________________

Address of Business ___________________________________________________________________________________
                                            City

Mailing Address if different    Township ____________________________________________________________________

 

2.

 

 

 

     INDIVIDUAL

3. NAME OF PERSON OR PERSONS, owning, conducting, transacting, or composing the above business, and the home post office address of each.

NAME OF PERSON

RESIDENCE ADDRESS (Street, City, State)

(Print)

 

(Print)

 

(Print)

 

(Print)

 

 

     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".

 

 

5. SIGNATURES OF ALL PERSONS LISTED ABOVE - Acknowledged before a

Notary Public.

(Signature)

 

 

(Signature)

 

 

(Signature)

 

 

(Signature)

 

 

 

STATE OF MICHIGAN COUNTY OF LAPEER

Subscribed and sworn to before me this __________________ day of _____________________________, 20_________ by all the persons listed above.

 

 

(Signature)

 

 

 

(Print)

 

Notary Public, Lapeer County Michigan.

My Commission Expires:

 

(Form below for use of County Clerk)

 

STATE OF MICHIGAN

COUNTY OF LAPEER

 

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 Lapeer, this _______________ day of __________________, 20_____________.

 

 

Marlene M. Bruns, Lapeer County Clerk              By: _____________________________________________

COUNTY/CLERK/DEPUTY COUNTY CLERK