CERTIFICATE OF ASSUMED NAME FOR A SOLE PROPRIETORSHIP, PARTNERSHIP, LIMITED PARTNERSHIP The undersigned, proposing to engage in business in Co un ty , North Carolina under an assumed name or a partnership name, do hereby certify that: 1. The name under which the business is to be conducted is: (Insert assumed or partnership name) 2. The names and addresses of all the owners of the business are: (Insert name and address of each owner) In witness whereof, this certificate is signed by each of the owners of said business, this day of , 20 . (seal) (seal) (seal) State of County of I, , a Notary Public, do hereby certify that on this day of , 20 , personally appeared before me who are all signers of the forgoing instrument, and each acknowledged the due execution thereof. Witness my hand and official seal, this the day of , 20 . Notary Public (Affix Notary Seal) My Commission Expires: Rev. 7/02.