Application For Registration Of Unincorporated Association Name
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Application For Registration Of Unincorporated Association Name Form. This is a Pennsylvania form and can be use in Fictitious Names Department Of State.
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Tags: Application For Registration Of Unincorporated Association Name, Pennsylvania Department Of State, Fictitious Names
PENNSYLVANIA DEPARTMENT OF STATE
BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS
Application for Registration of
Unincorporated Association Name
(54 Pa.C.S. § 502)
Document will be returned to the
name and address you enter to
the left.
Name
Address
City
State
Zip Code
Fee: $70
In compliance with the requirements of 54 Pa.C.S. § 502 (b) (relating to certain additions to register) the undersigned
unincorporated association, desiring to register with the Department of State the name under which it is doing business or operating,
hereby states that:
1.
The name to be registered is:
2. The address of the association is:
Number and street
City
State
Zip
County
3. The length of time, if any, during which the name has been used by the applicant is:
IN TESTIMONY WHEREOF, the undersigned association has caused this Application for Registration of
Unincorporated Association Name to be signed by a duly authorized officer this
day of
,
.
_____________________________________________
Name of Association
_____________________________________________
Signature
_____________________________________________
Title
American LegalNet, Inc.
www.FormsWorkFlow.com
Department of State
Bureau of Corporations and Charitable Organizations
P.O. Box 8722
Harrisburg, PA 17105-8722
(717) 787-1057
web site: www.dos.state.pa.us/corps
Instructions for Completion of Form:
A. Typewritten is preferred. If not, the form shall be completed in black or blue-black ink in order to permit
reproduction. The filing fee for this form is $70 made payable to the Department of State.
B. Under 15 Pa.C.S. § 135(c) (relating to addresses) an actual street or rural route box number must be used as an
address, and the Department of State is required to refuse to receive or file any document that sets forth only a post
office box address.
C. The following, in addition to the filing fee, shall accompany this form:
(1) Any necessary copies of form DSCB:17.2.3 (Consent to Appropriation of Name).
(2) Any necessary governmental approvals.
D. This form and all accompanying documents shall be mailed to the address stated above.
American LegalNet, Inc.
www.FormsWorkFlow.com
