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MINNESOTA SECRETARY OF STATE <br /> ,i I l STATE OF MINNESOTA CERTIFICATE OF FILM <br /> ASSUMED NAME I V <br /> Minnesota Statutes Chapter 333 <br /> Read the directions on reverse ride before completing. Flung fee: $25.00 <br /> Secretary of State <br /> The filing of an assumed name dons not Provide a user With exclusive rights to that name.The filing Is required for <br /> consumer protection in order to enable consumers to be able to Identify the true owner of a business. <br /> PLEASETYPE OR PRINT LEGIBLY IN BLACK INK FOR MICROFILMING PURPOSES. <br /> 1. State the exact assumed name under MICh the business is or will be conducted: (one business name per application) L <br /> C J�AA/ <br /> 2 State the address of the principal place of business. A complete street address or rural route and rural route box number is <br /> required; the address ewmt be a P.D.Bm <br /> 13q6l &raw� Ave.,. Q���✓�/�s� 1�1'1i✓ Sr ? 37 <br /> street ary stabs zip ooae <br /> 36 List the name and complete street address of all persons conducting business under the above Assumed Name. <br /> Attach addipnal sheet(s) if necessary. If fhe business owner is a corporation, provide the legal corporate name and <br /> registered office address of the corporation. <br /> Name Vawprint) street atY state ,Zfp <br /> C j4S 14 S T#T1 dAl 6;r4wl A v.e <br /> f Vr'V.S'11 11je MAI S:r3 3 7 <br /> 4. I certify that I am authorized to sign this CertlflCete and I further certify that I understand that by signing this CertlY}ic8te, I am <br /> subject to the penalties of perjury as set forth In Minnesota Statutes secdion 609.48 as If I had signed this certificate under <br /> oath. <br /> Signature (ONLY one person Usted in #fi is required to sign.) <br /> �S�'yt t(l <br /> Dais � PftName andTitle <br /> File Yowl <br /> Contact Person Daytime Phone Number <br /> os9209o7 Aev.lugs <br />