"Certificate of Withdrawal of Assumed Name (Domestic or Foreign Business Entity)" - Kentucky

Certificate of Withdrawal of Assumed Name (Domestic or Foreign Business Entity) is a legal document that was released by the Kentucky Secretary of State - a government authority operating within Kentucky.

Form Details:

  • Released on January 1, 2020;
  • The latest edition currently provided by the Kentucky Secretary of State;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Kentucky Secretary of State.

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C
K
OMMONWEALTH OF
ENTUCKY
M
A
, S
S
ICHAEL
DAMS
ECRETARY OF
TATE
_____________________________________________________________________________________________________________________________
Division of Business Filings
CWA
Certificate of Withdrawal of Assumed Name
P.O. Box 718
(Domestic or Foreign Business Entity)
Frankfort, KY 40602
(502) 564-3490
www.sos.ky.gov
______________________________________________________________________________________________
Pursuant to the provisions of KRS 365, the undersigned applicant applies to withdraw an assumed name and, for that purpose,
submits the following statements:
1. The assumed name to be withdrawn is ___________________________________________________________________.
(The name must be identical to the name on record with the Secretary of State.)
2. The assumed name has been discontinued by______________________________________________________________.
(Must be the exact name of the entity or partners)
3. This application will be effective upon filing, unless a delayed effective date and/or time is provided. The effective date or the
delayed effective date cannot be prior to the date the application is filed. The date and/or time is ____________________.
4. The date the original certificate was filed: __________________________________________________________________.
5. The “real name” is
):
(you must check one
_____a Domestic General Partnership
_____a Foreign General Partnership
_____a Domestic Limited Liability Partnership
_____a Foreign Limited Liability Partnership
_____a Domestic Limited Partnership
_____a Foreign Limited Partnership
_____a Domestic Business Trust
_____a Foreign Business Trust
_____a Domestic Corporation
_____a Foreign Corporation
_____a Domestic Limited Liability Company
_____a Foreign Limited Liability Company
6. The mailing address is:
____________________________________________ __________________________ ___________________ ___________
Street Address or Post Office Box Numbers
City
State
Zip
I declare under penalty of perjury under the laws of Kentucky that the forgoing is true and correct.
_________________________________________ ________________________ _________________ ___________
Signature of Authorized Party
Printed Name
Title
Date
(1/20)
C
K
OMMONWEALTH OF
ENTUCKY
M
A
, S
S
ICHAEL
DAMS
ECRETARY OF
TATE
_____________________________________________________________________________________________________________________________
Division of Business Filings
CWA
Certificate of Withdrawal of Assumed Name
P.O. Box 718
(Domestic or Foreign Business Entity)
Frankfort, KY 40602
(502) 564-3490
www.sos.ky.gov
______________________________________________________________________________________________
Pursuant to the provisions of KRS 365, the undersigned applicant applies to withdraw an assumed name and, for that purpose,
submits the following statements:
1. The assumed name to be withdrawn is ___________________________________________________________________.
(The name must be identical to the name on record with the Secretary of State.)
2. The assumed name has been discontinued by______________________________________________________________.
(Must be the exact name of the entity or partners)
3. This application will be effective upon filing, unless a delayed effective date and/or time is provided. The effective date or the
delayed effective date cannot be prior to the date the application is filed. The date and/or time is ____________________.
4. The date the original certificate was filed: __________________________________________________________________.
5. The “real name” is
):
(you must check one
_____a Domestic General Partnership
_____a Foreign General Partnership
_____a Domestic Limited Liability Partnership
_____a Foreign Limited Liability Partnership
_____a Domestic Limited Partnership
_____a Foreign Limited Partnership
_____a Domestic Business Trust
_____a Foreign Business Trust
_____a Domestic Corporation
_____a Foreign Corporation
_____a Domestic Limited Liability Company
_____a Foreign Limited Liability Company
6. The mailing address is:
____________________________________________ __________________________ ___________________ ___________
Street Address or Post Office Box Numbers
City
State
Zip
I declare under penalty of perjury under the laws of Kentucky that the forgoing is true and correct.
_________________________________________ ________________________ _________________ ___________
Signature of Authorized Party
Printed Name
Title
Date
(1/20)
FILING INSTRUCTIONS
CERTIFICATE OF WITHDRAWAL OF ASSUMED NAME
ASSUMED NAME
The certificate must state the assumed name under which business will be conducted or transacted. The assumed name must be a name that is distinguishable
upon the records of the Secretary of State from any other name previously filed and on record with the Secretary of State. A separate certificate must be filed for
each assumed name that is being adopted by the business.
KRS 365.015(3) requires the certificate of assumed name for an individual (sole proprietorship) to be filed with the county clerk where the person is deemed a
resident for the purposes of and under the provisions of KRS Chapter 355. An assumed name registration is effective for a term of five (5) years from the date it
is filed with the Secretary of State and may be renewed for a successive term upon filing a renewal certificate. A renewal certificate must be filed with the
Secretary of State within six (6) months prior to the expiration date. A renewal certificate filed with the Secretary of State renews the assumed name for a five-
year term. The business entity should arrange its own reminder of the renewal deadline, since the Secretary of State is not required to send renewal certificates.
Any certificate of assumed name in effect on July 15, 1998, shall continue in effect for five (5) years and may be renewed by filing a renewal certificate with the
Secretary of State.
REAL NAME
The real name is defined as follows:
The real name of a Domestic General Partnership is the name that includes the real name of each general partner;
The real name of a Domestic Registered Limited Liability Partnership is the name stated in its statement of registered limited liability partnership filed
pursuant to KRS Chapter 362;
The real name of a Domestic Limited Partnership is the name stated in its Certificate of Limited Partnership filed pursuant to KRS 362;
The real name of a Domestic Business Trust is the name set forth in its Declaration of Trust;
The real name of a Domestic Corporation is the name set forth in its Articles of Incorporation;
The real name of a Domestic Limited Liability Company is the name set forth in its Articles of Organization;
The real name of a Foreign General or Limited Partnership and of a Foreign Business Trust is the name recognized by the laws of the foreign state
under which it is formed as being the real name or the fictitious name adopted for use in this state;
The real name of a Foreign Limited Liability Partnership is the name stated in its statement of foreign qualification filed pursuant to KRS 362.1
The real name of a Foreign Corporation is the name set forth in its Articles of Incorporation or the fictitious name adopted for use in this state under
KRS 271B.15-060; or
The real name of a Foreign Limited Liability Company is the name set forth in its articles of organization or the fictitious name adopted for use in this
state under KRS 275.410.
PRINCIPAL OFFICE ADDRESS
The principal office is the office (in or out of this state) so designated in writing with the Office of the Secretary of State where the principal designated office of
the business entity is located. This address is where all correspondence from the Office of the Secretary of State (See Document Delivery) will be mailed..
EFFECTIVE DATE AND TIME/DELAYED EFFECTIVE DATE AND TIME
The document will be effective on the date and time of filing, unless a delayed effective date and/or time is specified. The effective date or the delayed effective
th
date cannot be prior to the date the application is filed. A delayed effective date may not be later than the 90
day after the date of filing.
DOCUMENT DELIVERY
A file stamped postcard will be sent to the principal office address. If the applicant wishes for the document to be sent to an alternate address other than the
principal office, a request must be submitted in writing affirming that request. Alternate address requests must be submitted with each document filed with the
Office of the Secretary of State.
WHO MAY SIGN
The document must be signed by:
• at least one partner authorized to do so by the partners of a Domestic or Foreign General Partnership;
• at least one partner authorized to do so by the partners of a Domestic or Foreign Registered Limited Liability Partnership;
• a general partner of a Domestic or Foreign Limited Partnership;
• the trustees of a Domestic or Foreign Business Trust;
• any person authorized to act for the Domestic or Foreign Corporation; or
• a member or manager authorized to act for the Domestic of Foreign Limited Liability Company.
NUMBER OF COPIES
If filing via mail or in person, one exact or conformed copy of the documents with the filing fee must be submitted to the address below. To make a copy of the
filing for delivery to the local county clerk’s office, visit www.sos.ky.gov and print a copy from the organization search tool.
FILING FEE
The filing fee for this document is $20.00. Checks should be made payable to the "Kentucky State Treasurer."
MAILING ADDRESS
OFFICE LOCATION
Michael Adams
Room 154, Capitol Building
Office of the Secretary of State
700 Capital Avenue
P.O. Box 718
Frankfort, KY 40601
Frankfort, KY 40602-0718
Hours of Operation: 8:00 AM-4:30 PM ET
CONTACT INFORMATION
If you have any questions, please feel free to visit our website at www.sos.ky.gov or call 502-564-3490.
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