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Certificate Of Assumed Name DOS-1338-f-l - New York
| Certificate Of Assumed Name Form. This is a New York form and can be used in General Corporations And Business Entities Secretary Of State . |
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Certificate of Assumed Name Pursuant to General Business Law§130 1. REAL NAME OF ENTITY: 1a. FICTITIOUS NAME, IF ANY, OF FOREIGN ENTITY (Not Assumed Name): NYS Department of State Division of Corporations, State Records and Uniform Commercial Code One Commerce Plaza, 99 Washington Ave, Albany, NY 12231-0001 www.dos.ny.gov 2. FORMED OR AUTHORIZED UNDER THE FOLLOWING NEW YORK LAW (Check one): Business Corporation Law Education Law Limited Liability Company Law Not-for-Profit Corporation Law Religious Corporations Law Revised Limited Partnership Act Other (specify law): 3. ASSUMED NAME: 4. PRINCIPAL PLACE OF BUSINESS IN NEW YORK STATE (MUST INCLUDE NUMBER AND STREET). IF NONE, CHECK THIS BOX STATE ADDRESS: AND PROVIDE OUT-OF- 5. COUNTY(IES) IN WHICH ENTITY DOES OR INTENDS TO DO BUSINESS: Albany Allegany Bronx Broome Cattaraugus Cayuga Chautauqua Chemung Chenango Clinton Columbia Cortland Delaware Dutchess Erie Essex Franklin Fulton Genesee Greene Hamilton Herkimer Jefferson Kings Lewis Livingston Madison Monroe Montgomery Nassau ALL COUNTIES (or check applicable county(ies) below) New York Niagara Oneida Onondaga Ontario Orange Orleans Oswego Otsego Putnam Queens Rensselaer Richmond Rockland St. Lawrence Saratoga Schenectady Schoharie Schuyler Seneca Steuben Suffolk Sullivan Tioga Tompkins Ulster Warren Washington Wayne Westchester Wyoming Yates 6. ADDRESS OF EACH LOCATION, INCLUDING NUMBER AND STREET, IF ANY, OF EACH PLACE WHERE THE ENTITY CARRIES ON, CONDUCTS OR TRANSACTS BUSINESS IN NEW YORK STATE. Use page 2 if needed. The address(es) must be a number and street, city state and zip code. The address(es) reflected in paragraph 6 must be within the county(ies) indicated in paragraph 5. If none, check the box: No New York State Business Location Name of Signer: Capacity of Signer (Check one): Officer of the Corporation Authorized Person Signature: General Partner of the Limited Partnership Manager of the Limited Liability Company Member of the Limited Liability Company Filer: Name: Mailing Address: City, State and Zip Code: NOTE: This form was prepared by the New York State Department of State. You are not required to use this form. All documents should be prepared under the guidance of an attorney. The certificate must be submitted with a $25 fee. For corporations, the Department of State also collects the following, additional, county clerk fees for each county in which a corporation does or intends to do business as indicated in paragraph 5: $100 for each county within New York City (Bronx, Kings, New York, Queens and Richmond) and $25 for each county outside New York City. All checks over $500 must be certified. (For office use only) DOS-1338-f-l (Rev. 05/13) American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 2 Page 2 (If needed) 6. ADDRESS OF EACH LOCATION, INCLUDING NUMBER AND STREET, IF ANY, OF EACH PLACE WHERE THE ENTITY CARRIES ON OR CONDUCTS OR TRANSACTS BUSINESS IN NEW YORK STATE: (Continued) DOS-1338-f-l (Rev. 05/13) American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2
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