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ASSUMED NAME CERTIFICATE

805 ilcs 405/1 Illinois Compiled Statutes

Number

 
STATE OF ILLINOIS
County of Kane
)
)
SS

This is to certify that the undersigned is (are) conducting and transacting a business in Kane County, Illinois, under the name

(not incorporated or a corporation)

and that the address of such business will be:

business street address

Kane County city, state, zip code

Phone (   )

The nature of the business or service to be conducted is: (explain clearly)

This is to further certify that the true and real full names of all persons owning, conducting or transacting such business, with the respective post-office addresses of each, are as follows:


owner's name printed


owner's name printed


home street address


home street address


city, state and zip code


city, state and zip code

Dated this day of , year .

Signatures of all persons who names are listed
above must be signed before a Notary Public.

 

___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
STATE OF ILLINOIS
County of Kane
)
)
SS

I,________________________________________________________________________________________________
a Notary Public in and for Kane County, Illinois, do hereby certify that____________________________
___________________________________________________________________________________
is (are) personally known to me to be the same person(s) whose name(s) appear above and has (have) appeared before me this day and read and signed this Certificate and acknowledged that the statements contained therein are true.

(notary seal)

____________________________________
Notary Public Signature