Fictitious Name Certificate Individual Form

A Fictitious Name Certificate Individual Form sample form.










           Certificate of Transaction of Business

            Under Fictitious Name - by Individual

 

                           Certificate

 

KNOW ALL MEN BY THESE PRESENTS:

 

That the undersigned does hereby certify the following:

 

1.  The undersigned is transacting or proposes to transact

business in the State of _____________ under the

fictitious name of ______________________________________.

 

2.  The principal place of said business is located at

______________________________________.

 

3.  The full name of the undersigned is _________________.

 

4.  The place of residence of the undersigned is _________

_______________________________________.

 

Dated _______________             ________________________

                                        [Signature]

 

 


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