CERTIFICATE OF PERSONS CONDUCTING BUSINESS UNDER AN ASSUMED NAME (ACT NO. 151 PA 1949)

STATE OF MICHIGAN , COUNTY OF INGHAM } ss          

The undersigned hereby certifies that he/she now owns (or) intends to own, conduct or transact business at:

                                                     _______________________________________________________

 City, Village or Township of ______________________________ Zip Code ________________ of Ingham County ,

  Michigan , under the assumed name, designation or style of:

Name of Business:  __________________________________________________________________________

Type of Business:  __________________________________________________________________________

The undersigned further certifies that the true or real full name and the address of the person(s) owning, conducting or

transacting said business is: (Print or type the name(s), of person(s) conducting business, street address, City, State, Zip)

____________________________________________________________________________________________________

____________________________________________________________________________________________________

____________________________________________________________________________________________________

In witness whereof, I/we have this date _____________________________, made and signed this certificate:

SIGNATURE(S) of persons conducting business under assumed name

_______________________________________________________

_______________________________________________________

_______________________________________________________

STATE OF MICHIGAN , COUNTY OF INGHAM } ss

On ___________________________ before me, a Notary Public, personally appeared the above named person(s), whose signatures appear above, and who executed the foregoing instrument, and he/she acknowledged to me that he/she executed the same and that they are all of the person(s) now owning, conducting and transacting or who intend to own, conduct or transact the business under the above name, style and designation.

___________________________________________________________Deputy Clerk

Notary Public _______________________________ County , Michigan

                                                                                                           Acting in _______________________________   County  

- - - - - - - - - -- - - - - - - - - - - - - - - - - - - DO NOT WRITE BELOW THIS LINE - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

This Certificate Expires on: ________________________

STATE OF MICHIGAN , COUNTY OF INGHAM }  ss

            I, _________________________, Clerk of Ingham County and Clerk of the 30^th  Judicial Circuit Court , do hereby certify that I have compared the above copy of Certificate setting forth the full names of the person(s) owning or transacting business under the name of: ____________________________________________________________________________________________________________together with the certificate of filing endorsed thereon, with the original certificate filed in my office and that it is a true copy thereof.

                                                                                                                  In testimony whereof, I have hereunto set my                                                                                                                        hand and affixed  the seal of said Circuit Court on                                                                                                                        ________________________                                                                               _______                _______                ______________________________________ County Clerk

                                                                                _______                _______                ______________________________________ Deputy Clerk

Filing Fee:  $10.00 Payable to: Ingham County Clerk , PO Box 179 , Mason , MI   48854

	Ingham County has a Regulation Eliminating Smoking in Public and Private Work Sites.  Visit:  http://www.cacvoices.org/ to review the Regulation and determine if it applies to your business.