TRADE NAME ASSIGNMENT SECRETARY OF STATE SFN 53850 (08-2016) For Office Use Only ID Number: WO Number: Filed: Expiration Date: By: 1. FILING FEE: $25.00 TYPE OR PRINT LEGIBLY SEE PAGES 2 AND 3 FOR FILING AND MAILING INSTRUCTIONS. For reference, see North Dakota Century Code, Chapter 47-25. 2. Trade name as registered with the Secretary of State (NOTE: A trade name cannot be altered on this form) 3. Assignor(s): (Owner(s) currently on record with the Secretary of State) Name Federal ID/Social Security Number COMPLETE ADDRESS Street/Rural Route Post Office Box City State ZIP+4 4. Trade name is being assigned to: (check one) Individual Corporation - Provide state of origin: Other - Define (see instructions): NOTE: This registration does not establish a North Dakota corporation or limited liability company. A North Dakota corporation or limited liability company must be an active organization already registered with the Secretary of State to be listed as the owner of a trade name. This registration does not grant authority to do business to any foreign (out-of-state) corporation or limited liability company. 5. Telephone number of assignee 6. Toll-free telephone number of assignee Married couple (information on both must be provided in #7) Limited liability company - Provide state of origin: 7. Assignee(s): Provide the name(s), federal ID or social security number(s), and principal place of business address(es) of the individual(s), corporation, or limited liability company acquiring the trade name. COMPLETE MAILING ADDRESS Federal ID/Social Assignee (Owner) Name Security Number Street/Rural Route Post Office Box City State ZIP+4 8. Address(es) of place(s) of business where assignee will use or display the trade name COMPLETE MAILING ADDRESS Street/Rural Route Post Office Box City State ZIP+4 Telephone Number 9. Provide in detail, the nature of business transacted ("general business" is not acceptable) 10. "I (We), the assignor(s), am (are) the owner(s) of this trade name and hereby assign this trade name to the assignee(s) with the good will of the business connected with the use thereof. I (We) authorize the Secretary of State to correct number 2 if not correctly reflected. I (We), the owner(s), say that I (we) have read the foregoing assignment, know the contents thereof, and believe the statements made to be true." Signature of assignor Signature of assignor Signature of assignor 11. Name of person to contact about this document Email address Date Date Date Daytime telephone number American LegalNet, Inc. www.FormsWorkFlow.com SFN 53850 (08-2016) Page 2 of 3 INSTRUCTIONS FOR TRADE NAME ASSIGNMENT To transfer ownership of a trade name registered with the Secretary of State, the registrant of record must file a Trade Name Assignment. Upon filing the Trade Name Assignment, the Secretary of State issues, in the name of the assignee, a new certificate for the remainder of the term of the five-year registration, or the last renewal thereof. An assignment filed with the Secretary of State does not extend the registration period. The expiration date is stated on the new certificate. The following numbers correspond to the numbered sections on page 1 of this form: 1. The assignment fee is $25. Checks must be payable to the "Secretary of State" and must be negotiable U.S. funds. Payment may also be made by credit card using Visa, MasterCard, Discover, or American Express. 2. Provide the trade name to be assigned. MUST BE EXACTLY AS REGISTERED WITH THE SECRETARY OF STATE. 3. Provide the full name(s) of the assignor(s) with their social security or Federal ID number(s) and complete address(es). The assignor(s) is/are the owner(s) of the trade name as currently recorded with the Secretary of State. If the owner is a corporation, a limited liability company, a limited partnership, a limited liability partnership, or a limited liability limited partnership filed with the Secretary of State, the assignor's name must be identical to that as registered. Privacy: In compliance with N.D.C.C., Section 47-25-08, social security or Federal ID numbers are not disclosed to the public. They are used by the Secretary of State to maintain accurate trade name registration files. Therefore, while voluntary disclosure is requested, failure to do so will not result in rejection of the registration. 4. Select the organizational structure that best defines the assignee. A domestic corporation or domestic limited liability company must have articles on file and be in existence with the Secretary of State before a trade name will be accepted for registration. THE REGISTRATION OF A TRADE NAME IS NOT AUTHORITY FOR A FOREIGN CORPORATION OR FOREIGN LIMITED LIABILITY COMPANY TO TRANSACT BUSINESS IN NORTH DAKOTA. A foreign corporation or foreign limited liability company must secure a certificate of authority before transacting business or obtaining any license or permit in North Dakota. If the assignee is a general partnership, a limited partnership, a limited liability partnership, or a limited liability limited partnership, DO NOT CONTINUE COMPLETION OF THIS FORM UNLESS A FICTITIOUS NAME CERTIFICATE IS ALREADY FILED. A general partnership, limited partnership, limited liability partnership, and limited liability limited partnership is required by law to file a Fictitious Name Certificate which achieves the same purpose of name protection (see North Dakota Century Code, Chapter 45-11). A blank form for the Fictitious Name Certificate can be obtained by contacting the Secretary of State's office. If the assignee of the trade name is an organizational structure defined as "other" and not mentioned above, the acceptance of a trade name will be assessed on a case-by-case basis. Clearly define any business structure classified as "other." Select the organizational structure that best defines the assignee. 5. The telephone number of the assignee's principal place of business is required. 6. If the assignee has a toll-free telephone number, please provide it. 7. Provide the full name(s) of the assignee(s), their social security or Federal ID number(s), and complete mailing address(es). If the assignee is a corporation or limited liability company, the address cannot be only a post office box; a street address must be provided. If a corporation or limited liability company is the new owner or user of the trade name, provide the name of the corporation or limited liability company in this number. (See Privacy statement in nu