Fill and Sign the What 3 States Have Llc Newspaper Publication Requirements Form

NOTIFICATION OF NAME CHANGE *In addition to filing this form, the business must also meet guidelines for publishing a legal notice. STATE OF ILLINOIS ) For office use only COUNTY OF COOK ) Certificate # ____________ Submit completed form and a check for $1.50 payable to: Cook County Clerk David Orr Bureau of Vital Statistics Attn: Assumed Name Registration Unit P.O. Box 642570 Chicago, IL 60602-2570 Let it be known that the Business __________________________________________________ _______________________________________ (full name of business) has had a partner(s) change hi s/her/their name as of ____________________________________ (enter date of name change) *Change of business name requires new filing of Assumed Na me Certificate. Location of Business: ______________________________________________________________________________ (street address, city, zip) The full name of the person(s) meeting legal requirements for a name change, PRINT NEW NAME FORMERLY DOING BUSINESS AS (Former name appearing on registration) _________________________________ ___________________________________ _________________________________ ___________________________________ who is/are the proprietor(s) of the business referenced above. Dated this _______________________ day of _______________________________________ Signature _____________________________________________________________________ Signature _____________________________________________________________________ ------------------------------------ -------------------------------------------------------------------------------- I, ________________________________________________________________, a Notary Public in Cook County, IL, do hereby ce rtify that [record owner(s) name(s) below] ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ is/are personally known to me to be the same person(s) whose name(s) subscribed to the foregoing instrument appeared before me this day in person and acknowledged that he/she read and signed the instrument and that the statements therein contained, and each thereof, are true. Notary Public _________________________________________________________________ ( sig natu re ) My commission expires on the _________________ day of _____________________________