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Assumed Business Name - Amendment 02 - Oregon
| Assumed Business Name - Amendment Form. This is a Oregon form and can be used in Assumed Business Name Business Registry Secretary Of State . |
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Assumed Business Name - Amendment Secretary of State - Corporation Division - 255 Capitol St. NE, Suite 151 - Salem, OR 97310-1327 - http//:www.FilingInOregon.com - Phone: (503) 986-2200 REGISTRY NUMBER: In accordance with Oregon Revised Statute 192.410-192.490, the information on this application is public record. We must release this information to all parties upon request and it will be posted on our website. For office use only Please Type or Print Legibly in Black Ink. Attach Additional Sheet if Necessary. 1) CURRENT BUSINESS NAME: 2) NEW BUSINESS NAME: (If Changed) 3) DESCRIPTION OF BUSINESS: 4) PRINCIPAL PLACE OF BUSINESS: (Street Address, City, State, Zip Code) 5) NAME OF AUTHORIZED REPRESENTATIVE: (One name only) CONTINUING or NEW 6) MAILING ADDRESS OF AUTHORIZED REPRESENTATIVE: (Street Address, City, State, Zip Code) 7) REGISTRANTS/OWNERS: (List name and publicly available street address of each person or entity who will conduct or transact business under the assumed business name.) (All new registrants must be listed. If registrants are withdrawing, both continuing and withdrawing registrants must be listed.) NEW REGISTRANTS (Name, Street Address, City, State, Zip Code) CONTINUING REGISTRANTS (Name, Street Address, City, State, Zip Code) WITHDRAWING REGISTRANTS 8) COUNTIES: Baker Benton Clackamas Clatsop Columbia Coos Crook Curry Deschutes Douglas Gilliam Grant Harney Hood River Jackson Jefferson Josephine Klamath Lake Lane Lincoln Linn Malheur Marion Morrow Multnomah Polk Sherman Tillamook Umatilla Union Wallowa Wasco Washington Wheeler Yamhill ALL COUNTIES (Statewide) 9) SIGNATURES: Any change requires a signature. New registrants must sign. If any registrants are WITHDRAWING, withdrawing Registrants or Authorized Representative must sign. By my signature, I declare as an authorized authority, that this filing has been examined by me and is, to the best of my knowledge and belief, true, correct, and complete. Making false statements in this document is against the law and may be penalized by fines, imprisonment or both. CONTACT NAME: (To resolve questions with this filing.) FEES If Changing Business Name $50 No Fee For Other Changes Processing Fees are nonrefundable. Please make check payable to "Corporation Division." PHONE NUMBER: (Please include area code.) Free copies are available at FilingInOregon.com, using the Business Name Search program. 02 - Assumed Business Name - Amendment (03/12) American LegalNet, Inc. www.FormsWorkFlow.com
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