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. (See Chapter 71 of the Texas Business and Commerce Code for other requirements and additional information) NAME IN WHICH BUSINESS IS, OR IS TO BE, CONDUCTED: __________________________________________________________________________________________________ PHYSICAL ADDRESS OF BUSINESS:_________________________________________________________________ CITY:____________________________STATE:________________________ZIP CODE:________________________ PERIOD DURING WHICH ASSUMED NAME WILL BE USED (not to exceed 10 years):_______________________ BUSINESS IS TO BE CONDUCTED AS (check one): Individual General Partnership Limited Partnership Other (name type):_________________________________________ CERTIFICATE OF OWNERSHIP I/We, the undersigned, are the owner(s) of the above business and my/our name(s) and address(es) given is/are true and correct, and there is/are no ownership(s) in said business other than those listed herein below. NAMES OF OWNERS NAME______________________________________SIGNATURE_______________________________________ (print or type) ADDRESS________________________________________________________________ZIPCODE_____________ NAME______________________________________SIGNATURE_______________________________________ (print or type) ADDRESS________________________________________________________________ZIPCODE_____________ NAME______________________________________SIGNATURE_______________________________________ (print or type) ADDRESS________________________________________________________________ZIPCODE_____________ THE STATE OF TEXAS COUNTY OF DENTON BEFORE ME, THE UNDERSIGNED AUTHORITY, on this day personally appeared____________________________ __________________________________________________________________________________________________ known to me to be the person(s) whose name(s) is/are subscribed to the foregoing instrument and acknowledged to me that __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 _____________________________________,____________ __________________________________________________ Notary Public in and for State of Texas JULI LUKE, DENTON COUNTY CLERK By:________________________________________, Deputy American LegalNet, Inc. www.FormsWorkFlow.com (seal)