Fill and Sign the Business Portal Rhode Island Nellie M Gorbea Form

STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS Office of the Secretary of State Corporations Division 148 W. River Street Providence, Rhode Island 0290 4-2615 (401) 222-3040 INSTRUCTIONS FOR FILING FICTITIOUS BUSINESS NAME STATEMENT Section 7-1.2-402, 7-16-9, and 7-13-2 of the Ge neral Laws of Rhode Island, 1956, as amended The attached form is designed to meet minimal statutor y filing requirements pursuant to the relevant statutory provision. This form and the information provided are not substitutes for the advice and services of an attorney and/or tax specialist. 1. Any entity organized and existing under the laws of any state or territory of the United States may transact business in this state under a fictitious business nam e provided that it files a Fictitious Business Name Statement (Form No. 624) with the Office of the Secretary of State, Corporations Division, at the above address. 2. When the Fictitious Business Name Statement is completed, signed and submi tted with the correct filing fee, the Fictitious Business Name Statement shall be filed. 3. The proposed fictitious business name must be “distinguis hable upon the records of the secretary of state.” This means the Office of the Secretary of State will deny a request for a name if such name is identical to or not distinguishable from any entity, name reserv ation, or registration on file with the Business Section of the Corporations Division. A preliminary name availability check can be made by checking the Name Availability Database on our website, or by phoning us at the above telephone number. This preliminary check is not statutorily required, is not binding upon the Secretary of State, and does not ensure t hat the name will be available upon filing the Fictitious Business Name Statement. It is suggested that you do not make any financial expendi tures or execute documents utilizing the name based upon a preliminary name availability che ck. The final determination as to availability of the name will be made when the statement is submitted for filing. 4. The statement must be accompani ed by a filing fee of $50.00, and payment should be made payable to the Rhode Island Secretary of State. 5. Upon filing the Fictitious Business Name Statement, the entity must be in good standing and current with the filing of its annual reports and the maintenance of its regist ered agent and registered office in this state. 6. The Fictitious Business Name Stat ement shall expire upon the filing of a Statement of Abandonment of Use of Fictitious Business Name or upon the dissolution of the applicant entity. 7. The Fictitious Business Name Stat ement shall be executed by an authorized o fficer, if the applicant entity is a corporation, or executed by an author ized person, if the applicant entity is a limited liability company or limited partnership. If you have any questions, please call us at (401) 222-3040, Monday through Friday, between 8:30 a.m. and 4:30 p.m. Instructions/Form 624 Revised: 12/05 Filing Fee: $50.00 ID Number: STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS Office of the Secretary of State Corporations Division 148 W. River Street Providence, Rhode Island 0290 4-2615 FICTITIOUS BUSINESS NAME STATEMENT Pursuant to the provisions of Secti on 7-1.2-402, 7-16-9 or 7-13-2 of the General Laws of Rhode Island, 1956, as amended, the undersigned business corporati on, limited liability company, or limited partnership hereby submits the following statement for authority to transact business in t he state of Rhode Island under a fictitious business name: 1. The legal name of the applicant business corporati on, limited liability company or limited partnership is: 2. The fictitious business name to be used is 3. The state or territor y under the laws of which it is incor porated, or ganized or formed is 4. The date of incor poration, or ganization or formation is 5. If a business cor poration, the address of its re gistered office within Rhode Island is 6. If a business cor poration, the business in which it is en gaged 7. App licant is otherwise authorized to do business in the state of Rhode Island. Under penalty of perjury, I declare that the information contained herein is true and correct. Date: Name of Applicant Corporation, Limited Liability Company or Limited Partnership By Signature of Authorized Officer of the Corporation or B y Signature of Aut horized Person for the Limited Liability Company or By Signature of Authorized Person for t he Limited Partnership Form No. 624 Revised: 12/05