(Certificate of Ownership for Unincorporated Business or Profession)
NAME IN WHICH BUSINESS IS OR WILL BE CONDUCTED __________________________________________________________________________________________
PHYSICAL OR MAILING ADDRESS OF BUSINESS_________________________________________________________________________________
CITY ___________________________________________TEXAS _________________________________
PERIOD IN WHICH ASSUMED NAME WILL BE USED (Not to Exceed 10 Yrs) _________________________________________________________________________________________
BUSINESS TO BE CONDUCTED (Please Check One):
__________ Sole Proprietorship __________General Partnership ___________ Limited Partnership
__________ Registered Limited Liability Partnership __________ Limited Liability Company __________ Other
CERTIFICATE OF OWNERSHIP
I/WE, the undersigned, are the owner/s of the above business and my/our name and address given is/are true and correct. There is/are no owner-ship(s) in said business other than those listed below.
_______________________________________ _____________________________________________
Name Signature
Address_________________________________ ___________________________________________
_______________________________________ ___________________________________________
Name Signature
Address________________________________ ___________________________________________
______________________________________ ___________________________________________
Name Signature
Address_______________________________ ___________________________________________
ACKNOWLEDGEMENT:
THE STATE OF TEXAS
COUNTY OF WALKER
BEFORE ME, the undersigned authority, on this day personally appeared________________________________
known to be the person whose name(s) is/are subscribed to the foregoing instrument and acknowledged to me that he/she signed the same for the purpose and consideration therein expressed.
GIVEN UNDER MY HAND AND SEAL OF OFFICE, this ________ day of ____________________, 2009.
My Commission Expires:____________________ _________________________________________
Notary Public in and for the State of Texas