Last Revised: 06/2019Page 1 of 4Form 524A Toll Free: 877.767.3453 | Central Ohio: 614.466.3910 OhioSoS.gov | business@OhioSoS.gov File online or for more information: OhioBusinessCentral.gov Filing Form Cover LetterPlease return the approval certificate to: Address: City: ZIP Code: Phone Number: E-mail Address: Check here if you would like to receive important notices via e-mail from the Ohio Secretary of State's office regarding Business Services. Check here if you would like to be signed up for our Filing Notification System for the business entity being created or updated by filing this form. This is a free service provided to notify you via e-mail when any document is filed on your business record. Please make checks or money orders payable to: "Ohio Secretary of State" Type of Service Being Requested: (PLEASE CHECK ONE BOX BELOW) Regular Service: Only the filing fee listed on page one of the form is required and the filing will be processed in approximately 3-7 business days. The processing time may vary based on the volume of filings received by our office. Expedite Service 1: By including an Expedite fee of $100.00, in addition to the regular filing fee on page one of the form, the filing will be processed within 2 business days after it is received by our office. Expedite Service 2: By including an Expedite fee of $200.00, in addition to the regular filing fee on page one of the form, the filing will be processed within 1 business day after it is received by our office. This service is only available to walk-in customers who hand deliver the document to the Client Service Center. Expedite Service 3: By including an Expedite fee of $300.00, in addition to the regular filing fee on page one of the form, the filing will be processed within 4 hours after it is received by our office, if received by 1:00 p.m. This service is only available to walk-in customers who hand deliver the document to the Client Service Center. Preclearance Filing: A filing form, to be submitted at a later date for processing, may be submitted to be examined for the purpose of advising as to the acceptability of the proposed filing for a fee of $50.00. The Preclearance will be complete within 1-2 business days. Name (Individual or Business Name): To the Attention of (if necessary): State American LegalNet, Inc. www.FormsWorkFlow.com Last Revised: 06/2019Page 2 of 4Form 524AToll Free: 877.767.3453 Central Ohio: 614.466.3910 OhioSoS.gov business@OhioSoS.gov File online or for more information: OhioBusinessCentral.gov Mail this form to one of the following: Regular Filing (non expedite) P.O. Box 788 Columbus, OH 43216 Expedite Filing (Two business day processing time. Requires an additional $100.00) P.O. Box 1390 Columbus, OH 43216 Trade Name or Fictitious Name Registration Update Filing Fee: $25 Form Must Be Typed Complete the information in this section if box (1) is checked aboveNew Registrant's Address (1) Assignment of Registered Name (116-RNA) (2) Change of Nature of Business (999-GEN) (3) Change of Address for Registrant (176-RNB) (4) Cancellation of Registration (184-RNX) (5) Change of Partners of Registrant, if Registrant is a General Partnership (999-GEN) Trade Name or Fictitious Name Registration Number Name of Current Registrant New Registrant's Name New Registrant's Charter/Registration/License Number in Ohio (if applicable) Mailing Address City State ZIP CodeIf new registrant is a General Partnership NOT registered in Ohio pursuant to ORC 1776, please provide the name and address of at least one general partner.NameAddress Note: Pursuant to OAG 89-081, if a general partner is a foreign corporation/limited liability company, it must be licensed to transact business in Ohio.Form 524A Prescribed by: For screen readers, follow instructions located at this path. American LegalNet, Inc. www.FormsWorkFlow.com Last Revised: 06/2019Page 3 of 4Form 524A By signing and submitting this form to the Ohio Secretary of State, the undersigned hereby certifies that he or she has the requisite authority to execute this document. Required Application must be signed by the registrant or an authorized representative. If authorized representative is an individual, then they must sign in the "signature" box and print their name in the "Print Name" box. The general nature of business conducted by the registrant: Mailing Address City State ZIP Code Signature By (if applicable) Print Name Complete the information in this section if box (2) is checkedIf authorized representative is a business entity, not an individual, then please print the business name in the "signature" box, an authorized representative of the business entity must sign in the "By" box and print their name in the "Print Name" box.Registrant's New Address Complete the information in this section if box (3) is checked No additional information required if box (4) is checked above. Please sign form below. Complete the information in this section if box (5) is checkedNew General Partner(s) names(s) and addressesAddressName Note: Pursuant to OAG 89-081, if a general partner is a foreign corporation/limited liability company, it must be licensed to transact business in Ohio. American LegalNet, Inc. www.FormsWorkFlow.com Last Revised: 06/2019Page 4 of 4Form 524AThis form should be used if you wish to (1) assign a name registration to a new registrant; (2) change the nature of business of an existing name registration; (3) provide a new address for the current registrant; (4) cancel the registration; or (5) provide a new or updated general partners name(s). Please select the box that indicates what action you wish to take with respect to your trade name or fictitious name, provide the exact trade name or fictitious name, registration number assigned by our office, and provide the name of the current registrant on file with our office. You may select more than one box if necessary. Follow these additional instructions if box (1) is checked. Ohio Revised Code Section 1329.06 permits a trade name or fictitious name to be assigned. In other words, the current registrant of a trade name or fictitious name may assign the trade name or fictitious name to another person or entity. If you assign your trade name or fictitious name, the assignment may be recorded with the secretary of state using this form. Please provide the name and address of the new registrant if box (1) is checked. If the new registrant is a general partnership, and the partnership has not filed a Statement of Partnership Authority pursuant to Ohio Revised Code chapter 1776, then please be provide the name and address of at least one general partner. If the general partner is a foreign corporation or foreign limited liability company, then the foreign business entity must be licensed/registered to do business in Ohio. Follow these additional instructions if box (2) is checked. If the nature of the business conducted under the trade name or fictitious name has changed, please provide a new description. For example, if you indicated on the original name registration application that the nature of the business is the 223sale of children's clothing224 and later expand to include the 223sale of children's toys and books,224 you can use this form to provide an updated description of the nature of the business. Note: Ohio law does not require that this information be updated with the secretary of state. The option is provided in the event you wish to update the information on record with our office. Follow these additional instructions if box (3) is checked. Ohio Revised Code Section 1329.07 requires the registrant of a trade name or fictitious name to report a change of address to the secretary of state. Please provide a new business address for the registrant. Follow these additional instructions if box (4) is checked. No additional information is required if box (4) is checked. Please remember to sign the form. Follow these additional instructions if box (5) is checked. If the registrant of a trade name or fictitious name is a general partnership and its partners (as reported on the original name registration application) change, please provide the name and