Fill and Sign the Registration of Firm Names Form

STATE OF WISCONSIN, County of _____________________________________ Subscribed and sworn to before me on______________________by the above named person(s). Signature of notary or other person authorized to administer an oath (as per s. 706.06, 706.07) ____________________________________________________ Print or type name: ____________________________________________________ Title ____________________________ Date commission expires: _______________. Name and return address: This document was drafted by: (print or type name below) Application is hereby made to register such firm name with the Register of Deeds for the purpose of complying with the requirement of section 134.17 of the Wisconsin Statutes. ___________________________________________________ _________________________________________________ Signature Signature ___________________________________________________ _________________________________________________ Print name Print name Recording area Use black ink REGISTRATION OF FIRM NAMES STATE OF WISCONSIN, COUNTY OF __________________________ _____________________________________________, being first duly sworn deposes and says that he/she is _____________________________________ of the firm doing business under the name of: __________________________ _______________________________________________________________ and located at: ___________________________________________________ _____________________________________________ and that such firm is a (circle one) sole trader co-partnership association engaged in the business of __________________________________________________ and that the only persons interested financially in such business or using such name are the following: *Names of persons signing in any capacity must be typed or printed below their signature. WRDA 12/20/2001 NAME RELATIONSHIP TO THE BUSINESS ADDRESS