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, Sec. 1, Title 4 – Business and Commerce Code) NAME IN WHICH BUSINESS IS OR WILL BE CONDUCTED __________________________________________________________________________________________________ PHYSICAL ADDRESS OF BUSINESS_________________________________________________________________ CITY:____________________________STATE:________________________ZIP CODE:________________________ PERIOD (not to exceed 10 years) DURING WHICH ASSUMED NAME WILL BE USED:_______________________ 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 _____________________________________,____________ (seal) __________________________________________________ Notary Public in and for State of Texas CYNTHIA MITCHELL, DENTON COUNTY CLERK By:________________________________________, Deputy American LegalNet, Inc. www.FormsWorkflow.com