New Business Name Registration {08-557}

08-557 Rev 02/08/17 NEW Business Name Registration 1 of 2 A corresponding Alaskan Business License must be obtained first in order to register an unincorporated (perAS 10.35.500(1)) or DBA business name. For more information, go to www.BusinessLicense.Alaska.Gov The unincorporated or DBA business name must be distinguishable from any other organized entity, reservedname, or registered name on record. For more information go to www.Corporations.Alaska.Gov The unincorporated or DBA business name registration cannot contain a corporate identifier, such as, but notlimited to: corporation; limited liability company; or an abbreviation of any of these words. Entities already on record with this office under Corporations Statutes, Title 10, do not need to file a businessname registration for the entity222s legal name. COR Corporations Section tate Office Building, 333 Willoughby Avenue, 9th Floor PO Box 110806, Juneau, AK 99811-0806 Phone: (907) 465-2550 Fax: (907) 465-2974 Email: corporations@alaska.gov Website: Corporations.Alaska.Gov NEW Business Name Registration (AS 10.35) 1. Important: AS 10.35.040(b) and AS 10.35.050 Under Corporation Statutes, Title 10, a person conductin business (as an unincorporated business or DBA) may register its name (for the purpose of exclusive rights) if the name is distinguishable on record of the department from the name of any other organized entity, reserved name or registered name . 227 AS 10.35.040 Under Business Licensing Statutes, AS 43.70, there is no restriction on issuing multiple business licenses with the exact same name. The department is required to issue a business license under AS 43.70, even if exclusive rights to a name have been secured under Corporation Statutes, Title 10, AS 10.35. The person with exclusive rights may seek a court order to prohibit the use by another person of a name that is not distinguishable on record from the business name registration. The person with exclusive rights may seek a court order and damages through the Alaska Court System. 227 AS 10.35.040(b) 2. Fee: $25 Nonrefundable Filing Fee (CORF) 3 AAC 16.010(a) Mail this form and the non-refundable $25 filing fee in U.S. dollars to the letterhead address. Make the check or money order payable to the State of Alaska, or use the attached credit card payment form. 3. NEW Business Name Registration Information: AS 10.35.050 Unincorporated or DBA Business Name: (must exactly match the name on the Alaska Business License) Alaska Business License Number (mandatory): BL Ownership: Sole Proprietor Partnership Entity (INC, LLC, etc.) FOR DIVISION USE ONLY T HE S TATE ALASKA of Department of Commerce, Community and Economic Development Division of Corporations, Business and Professional Licensing American LegalNet, Inc. www.FormsWorkFlow.com 08-557 Rev 03/14/17 NEW Business Name Registration 2 of 2 4. Business Address: AS 10.35.050 Address: Address: 5. Owner of the Business: AS 10.35.050 Name of Owner: If the owner is an entity, then provide the Alaska Entity Number: Mailing Address: 6. If the business is owned by a partnership (in item #3), then list all additional owners (partners): (Attach an 8.5x11 supplement if necessary) AS 10.35.050 Name of Owner: Mailing Address: 7. Business Statements: AS 10.35.050 Nature of the Business is: 8. Required Signature: AS 10.35.050 Per AS 10.35.050 the NEW Business Name Registration must be signed by the owner of the business. If the business (listed in Item #3) is a Sole Proprietor then the sole individual (listed in Item # above)must sign. If the business (listed in Item #3) is a Partnership then one of the owning partners (listed on Item # or Item #) must sign. If the business (listed in Item #3) is owned by an entity (listed in Item # above) then the signer must be on record with this office as an authorized signer for the owning entity and identify their signing authority, suchas: corporation President or LLC Member. Example: John Doe, President of owning entity XYZIncorporated. Signature: Date: Printed Name: Signer222s relation to business: American LegalNet, Inc. www.FormsWorkFlow.com 08-561 Rev 7/14/16 Contact Information Return this form with your filing This information may be used by the Division to assist with processing your attached filings This form will not be filed for record, or appear online COR Corporations Section State Office Building, 333 Willoughby Avenue, 9th Floor PO Box 110806, Juneau, AK 99811-0806 Phone: (907) 465-2550 Fax: (907) 465-2974 Email: corporations@alaska.gov Website: Corporations.Alaska.Gov Contact Information Entity Information Enter your entity information as it appears on this filing. Entity Name: AK Entity #: Contact Person Whom may we contact with any questions or problems with this filing? Company: Contact: Mailing Address: Address: City: State: ZIP: Phone: Email: Document Return Address Provide an address for the return of your filed documents. Return my filings to the address provided ABOVE Return my filings to this address provided BELOW Company: Contact: Mailing Address: Address: City: State: ZIP: FOR DIVISION USE ONLY T HE S TATE ALASKA of Department of Commerce, Community and Economic Development Division of Corporations, Business and Professional Licensing American LegalNet, Inc. www.FormsWorkFlow.com All major credit cards are accepted. For security purposes, do not email credit card information. Include this credit card payment form with your application. Name of Applicant or Licensee: Program Type: License Number (if applicable): I wish to make payment by credit card for the following (check all that apply): AMOUNT Application Fee: License or Renewal Fee: Other (name change, wall certificate, fine, duplicate license, exam, etc.): 1. 2. TOTAL: Name (as shown on credit card): Mailing Address: Phone Number: Email (optional): Signature of Credit Card Holder: 08-4438 Rev 12/26/18 Credit Card Payment Form (all major cards accepted) State of Alaska Department of Commerce, Community, and Economic Development Division of Corporations, Business and Professional Licensing PO Box 110806, Juneau, AK 99811 Phone: (907) 465-2550 Credit Card Payment Form CREDIT CARD INFO: Your payment cannot be processed unless all fields are completed! All four fields MUST be completed! This section will be destroyed after the payment is processed. 1. Account Number : 2. Expiration Date: 3. Billing ZIP Code: 4 . Security Code : FOR DIVISION USE ONLY T HE S TATE ALASKA of Department of Commerce, Community , and Economic Development Division of Corporations, Business and Professional Licensing American LegalNet, Inc. www.FormsWorkFlow.com