OFFICE OF JOHN F. WARREN COUNTY CLERK, DALLAS COUNTY, TEXAS 509 MAIN STREET, DALLAS, TEXAS 75202 ASSUMED NAME RECORDS CERTIFICATE OF OWNERSHIP FOR UNINCORPORATED BUSINESS OR PROFESSION NOTICE: “CERTIFICATES OF OWNERSHIP” ARE VALID ONLY FOR A PERIOD NOT TO EXCEED 10 YEARS FROM THE DATE FILED IN THE COUNTY CLERK’S OFFICE (Chapter 36, Sect. 1, Title 4-Business and Commerce Code) (This certificate executed is to be filed immediately with the County Clerk) NAME IN WHICH BUSINESS IS OR WILL BE CONDUCTED __________________________________________________________________________________ print or type BUSINESS ADDRESS ______________________________________________________________ CITY_________________________________________STATE__________ ZIP CODE___________ PERIOD (not to exceed 10 years) DURING WHICH ASSUMED NAME WILL BE USED: __________________ BUSINESS IS TO BE CONDUCTED AS (Check Which One) : Proprietorship Joint Venture Real Estate Investment Trust Sole Practitioner General Partnership Joint Stock Company Limited Partnership Other __________________ CERTIFICATE OF OWNERSHIP We, the undersigned, are the owner ____________ _______________of the above business and my/our name _______________________ and address _________________ _____________________________given is /are true and correct, and there is/are no ownership(s) in said business other than those listed herein below. NAME OF OWNERS NAME _______________________________ SIGNATURE _______________________________________ (print or type) ADDRESS _______________________________________________________ ZIP CODE _____________ Residence (print or type) NAME _______________________________ SIGNATURE _______________________________________ (print or type) ADDRESS _______________________________________________________ ZIP CODE ______________ Residence (print or type) THE STATE OF TEXAS,COUNTY OF DALLAS BEFORE ME, THE UNDERSIGNED AUTHORITY, on this day personally appeared __________________ ___________________________________________ Known to me to be the person ___ he ____ is/are the owner(s) of the above-named business and that ___________ he _________ signed the same for the purpose and consideration therein expressed. GIVEN UNDER MY HAND AND SEAL OF OFFICE, on __________________________________,20 _______ JOHN F. WARREN, COUNTY CLERK By _____________________________________Deputy ____________________________________________ Form No. 424 (Rev. 9-30) Notary Public in and for Dallas County American LegalNet, Inc. www.FormsWorkflow.com CERTIFICATE OF OWNERSHIP NAME OF OWNERS NAME _______________________________ SIGNATURE _______________________________________ (print or type) ADDRESS _______________________________________________________ ZIP CODE _____________ Residence (print or type) NAME _______________________________ SIGNATURE _______________________________________ (print or type) ADDRESS _______________________________________________________ ZIP CODE ______________ Residence (print or type) NAME _______________________________ SIGNATURE _______________________________________ (print or type) ADDRESS _______________________________________________________ ZIP CODE ______________ Residence (print or type) NAME _______________________________ SIGNATURE _______________________________________ (print or type) ADDRESS _______________________________________________________ ZIP CODE ______________ Residence (print or type) NAME _______________________________ SIGNATURE _______________________________________ (print or type) ADDRESS _______________________________________________________ ZIP CODE ______________ Residence (print or type) NAME _______________________________ SIGNATURE _______________________________________ (print or type) ADDRESS _______________________________________________________ ZIP CODE ______________ Residence (print or type) NAME _______________________________ SIGNATURE _______________________________________ (print or type) ADDRESS _______________________________________________________ ZIP CODE ______________ Residence (print or type) BEFORE ME, THE UNDERSIGNED AUTHORITY, on this day personally appeared __________________ ____________________________________________ Known to me to be the person ___ he ____ is/are the owner(s) of the above-named business and that ___________ he _________ signed the same for the purpose and consideration therein expressed. GIVEN UNDER MY HAND AND SEAL OF OFFICE, on __________________________________,20 _______ JOHN F. WARREN, COUNTY CLERK By _____________________________________Deputy ____________________________________________ Form No. 424 (Rev. 9-30) Notary Public in and for Dallas County American LegalNet, Inc. www.FormsWorkflow.com