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Kentucky Secretary of State TREY G RAYSON _______________________________________________________________________________________________________________ Division of Corporations BUSINESS FILINGS P.O. Box 718 Frankfort, KY 40602 (502) 564-2848 http://www.sos.ky.gov/ Certificate of Assumed Name ASN _______________________________________________________________________________________________________________ 1. This certifies that the assumed name of: _____________________________________________________________________________________________________________ 2. has been adopted by: _____________________________________________________________________________________________________________ 3. which is the “real name” of (you must check one): _____a Domestic General Partnership _____a Foreign General Partnership _____a Domestic Limited Liability Partnership _____a Foreign Limited Liability Partnership _____a Domestic Limited Partnership _____a Foreign Limited Partnership _____a Domestic Business Trust _____a Foreign Business Trust _____a Domestic Corporation _____a Foreign Corporation _____a Domestic Limited Liability Company _____a Foreign Limited Liability Company 4. organized and existing in the state or country of _____________________________________, and whose 5. address is:_____________________________________________________________________________ ________________________________________________________________________\ __________ The certificate of assumed name is executed by: ________________________________________________ ____________________________________________ (Signature) (Signature) ________________________________________________ ____________________________________________ (Type or Print Name) (Type or Print Name) ________________________________________________ ____________________________________________ (Day/Month/Year) (Day/Month/Year) ASN (11/07) Certificate of Assumed Name Filing Instructions ASSUMED NAME The certificate must state the assumed name under which business will be conducted or transacted. The assumed name must be a name that is distinguishable upon the records of the Secretary of Stat e from any other name previously filed and on record with the Secretary of State. A separate certificate must be filed for eac h assumed name that is being adopted by the business. NOTE: KRS 365.015(3) requires the certificate of assumed name for an individual (sole proprietorship) to be filed with the county clerk where the person is deemed a resident for the purposes of and under the provisions of KRS Chapter 355. REAL NAME The “Real Name” is defined as follows: (1) The real name of a Domestic General Partnership is the name that includes the real name of each general partner. (2) The real name of a Domestic Registered Limited Liability Partnership is the name stated in its statement of registered limited liability partnership filed pursuant to KRS Chapter 362; (3) The real name of a Domestic Limited Partnership is the name stated in its Certificate of Limited Partnership filed pursuant to KRS Chapter 362; (4) The real name of a Domestic Business Trust is the name set forth in its Declaration of Trust; (5) The real name of a Domestic Corporation is the name set forth in its Articles of Incorporation; (6) The real name of a Domestic Limited Liability Company is the name set forth in its Articles of Organization; (7) The real name of a Foreign General or Limited Partnership and of a Foreign Business Trust is the name recognized by the laws of the foreign state under which it is formed as being the real nam e or the fictitious name adopted for use in this state; (8) The real name of a Foreign Limited Liability Partnership is the name stated in its statement of foreign qualification filed pursuant to KRS Chapter 362.1 (9) The real name of a Foreign Corporation is the name set forth in its Articles of Inco rporation or the fictitious name adopted for use in this state under KRS 271B.15-060; (10) The real name of a Foreign Limited Liability Company is the name set forth in its articles of organization or the fictitious name adopted for use in this state under KRS 275.410. NOTE: Kentucky characterizes a Joint Venture as a form of a partnership. Therefore, if a Joint Venture is conducting business under a name that does not include the real name of one of the partners, it must also file a certificate of assumed name with the Secre tary of State. WHO MAY SIGN The Certificate of Assumed Name must be signed by: (1) at least one partner authorized to do so by the partners of a Domestic or Foreign General Partnership (also includes a Joi nt Venture); (2) at least one partner authorized to do so by the partners of a Domestic or Foreign Registered Limited Liability Partnership ; (3) a general partner of a Domestic or Foreign Limited Partnership; (4) the trustees of a Domestic or Foreign Business Trust; (5) any person authorized to act for t he Domestic or Foreign Corporation; (6) a member or manager authorized to act for the Domestic of Foreign Limited Liability Company. NUMBER OF COPIES Submit the original signed Certificate and at least one exact or conformed copy (may be a photocopy). All file-stamped copies will be returned to you as evidence of filing. One file-stamped copy mu st then be filed with the county clerk of the county where the entity is deemed a resident for the purposes of and unde r the provisions of KRS Chapter 355. FILING FEE AND MAILING ADDRESS The filing fee is $20.00. Your check should be made payable to the “Kentucky State Treasurer”. MAILING ADDRESS OFFICE LOCATION Trey Grayson Room 154, Capitol Building Secretary of State 700 Capital Avenue P O Box 718 Frankfort, KY 40601 Frankfort, KY 40602-0718 WEB SITE ADDRESS Our home page address is http://www.sos.ky.gov . Click on “On Line Business Database” for info rmation on status of all business entities in Kentucky. Forms are also available on our web site. For name availability, call (502) 564-2848, press 2, and then press 1. For further information, call (502) 564-2848, press 2 and the press 5 or try our web site. NOTE: An assumed name registration is effective for a term of fi ve (5) years from the date it is filed with the Secretary of State and may be renewed for a successive term upon filing a renewal certificate. A renewal certificate must be filed with the Secretary of State within six (6) months prior to the expiration date. A renewal certificate fil ed with the Secretary of State renews the assumed name for a fiv e-year term. The business entity should arrange its own reminder of the renewal deadline, since the Secretary of State is not required to se nd renewal certificates. Any certificate of assumed name in effect on July 15, 1998, shall continue in effect for five (5) years and may be renewed by filing a renewal certificate with the Secretary of State.

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