NOTICE: THIS CERTIFICATE OF WITHDRAWAL PROPERLY EXECUTED IS TO BE FILED IMMEDIATELY WITH THE COUNTY CLERK, AS PROVIDED BY LAW. WITHDRAWAL NOTICE OF AN ASSUMED NAME (DBA) COUNTY CLERK, FORT BEND COUNTY 301 JACKSON, RICHMOND, TEXAS 77469-3108 | (281) 341-8685 LAURA RICHARD NAME OF BUSINESS BEING ABANDONED ___________________________________________________________________________________________________________ BUSINESS ADDRESS: ___________________________________________________________________________________________________ CITY: ___________________________________________ STATE: ___________________________ ZIP CODE: ________________ 1. GIVE DATE (IF KNOWN) ORIGINAL ASSUMED NAME WAS FILED IN THIS OFFICE:________________________________________ 2. NAME OTHER FILING OFFICES, IF ANY, WHERE YOU FILED THE SAME ASSUMED NAME: _________________________________ Each of the undersigned has this day withdrawn from or disposed of his interest in the above mentioned business and is no longer connected with the same, and will not be responsible for debts contracted by said business after the filing of this Withdrawal Notice as prescribed by law. PRINT OR TYPE NAME. NOTE: SIGNATURE(S) MUST BE SIGNED IN FRONT OF A NOTARY. NAME:_________________________________________ (PRINT OWNER OR CORPORATION NAME) (PRINT OR TYPE NAME OF BUSINESS) SIGNATURE: ______________________________________________ ________________________________________________________ (IF CORPORATION, PRINT NAME AND TITLE) ADDRESS: _______________________________________________________________________________________________ NAME:_________________________________________ (PRINT ADDITIONAL OWNER'S NAME) SIGNATURE: ______________________________________________ ADDRESS: _______________________________________________________________________________________________ THE STATE OF TEXAS COUNTY OF FORT BEND } } Before me, the undersigned authority, on this day personally appeared ____________________________________________________________ those person(s) whose name(s) are listed above known to me to be the person(s) subscribed to the foregoing instrument and acknowledged to me that they are the owners(s) of the above named business and that they signed the same for the purpose and consideration herein expressed. GIVEN UNDER MY HAND AND SEAL OF OFFICE, THIS ___________ DAY OF __________________________________, __________ ____________________________________________________________ SIGNATURE OF NOTARY PUBLIC/DEPUTY COUNTY CLERK REVISED 01/01/2015 American LegalNet, Inc. www.FormsWorkFlow.com