Certificate Of Assumed Business Name {30353}

INSTRUCTIONS: 1. Use 8275224 x 11224 white paper for attachments. 2. Please TYPE or PRINT in INK. 3. Please visit our office on the web at www.sos.IN.gov 4. Make check or money order payable to the Secretary of State. 5. Submit original completed paperwork and payment to: 302 West Washington Street, Room E-018, Indianapolis, IN 46204. NOTE: This form cannot be used for county filing of an assumed business name. NOTE: This form can only be used to apply for one assumed business name. Please submit a separate form and fee for each assumed business name. (SOS use only) (If different from above 226 SOS use only) American LegalNet, Inc. www.FormsWorkFlow.com (month, day, year) (number and street) (number and street) (month, day, year) American LegalNet, Inc. www.FormsWorkFlow.com