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<br />" <br /> <br /> <br />MINNESOTA SECRETARY OF STATE <br /> <br />. .-. ... <br /> <br />Read the directions on reverse side before completing. <br /> <br />Filing fee: $25.00 <br /> <br />51 ATE OF MINNESOTA <br />FILED ~ ~__.' <br /> <br />AU$ '31 2000 <br /> <br />;tj;(~~. <br /> <br />" I <br /> <br />CERTIFiCATE OF <br />ASSUMED NAME <br /> <br />Minnesota Statutes Chapter 333 <br /> <br />Secretary of State <br />The filing of an assumed name does not provide a user with exclusive rights to that name. The filing Is required for <br />consumer protectlc;>>n In order to enable consumers to be able to Identify the true owner of a business. <br /> <br />PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK FOR MICROFILMING PURPOSES. <br /> <br />1. State the exact assu~~ ";levX'~ if ~-:;~Fr..1I be conducted: (one buslne.. name per ePPlloauo> IC <br /> <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 cannot be. a P.D.Box. <br /> <br />13q~CJ Gra#~ I/v~ <br /> <br />Street <br /> <br />BV(NJv;!tfL <br />City <br /> <br />/'IlAi <br /> <br />State <br /> <br />sr?J7 <br />Zip code <br /> <br />3. List the name and complete street address of all persons conducting business under the above Assumed Name. <br />Attach additional sheet(s) if necessary. If the business owner Is a corporation, provide the legal corporate name and . <br />registered office address of the corporation. <br /> <br />Name (please print) Street <br />CAsH ST,4-TION }UC <br /> <br />, <br /> <br />City State Zip <br />1 "5 'I G1 Cra'/~ Av~ <br /> <br />f v(Ns,,;jlll M/I/ 'S- JS S 7 <br /> <br />4. I certify that I am authorized to sign this certificate and I further certify that I understand that by signing this certificate, I am <br />subject to the penalties of perjury as set forth In Minnesota Statutes section 609.48 as If I had signed this certificate under <br /> <br /><:[ , (/-ao <br />Date <br /> <br />... <br /> <br />~ A M:<- <br />Signature (ONLY one person listed in #3 is required to slgn.) <br />In Af!-t-'I/ Sn-r ,rih <br />Print Name and Tide <br />fI1ecrt I/- Sml'ih qSJ- ~98 YO!)..! <br />Contact Person Daytime Phone Number <br /> <br />oath. <br /> <br />.l <br /> <br />05920807 Rev. 11/98 <br />