Office of the Minnesota Secretary of State

Assumed Name | Amendment to Assumed Name

Read the instructions before completing this form.

Filing Fee: $50 for expedited service in-person and online filings, $30 if submitted by mail
The filing of an assumed name does not provide a user with exclusive rights to that name. The filing is required for consumer
protection in order to enable consumers to be able to identify the true owner of a business.
Note: Information provided when filing a business entity is public data and may be viewable online. This includes but is not limited to
all individual names and addresses.

1. List the exact assumed name under which the business is or will be conducted: (Required)

2. Principal Place of Business: (Required)

Street Address (A PO Box by itself is not acceptable) City State Zip

3. List a Mailing Address if you cannot receive mail at the principal place of business address:
If you're removing the Mailing Address, you must list "NONE".

Street Address City State Zip

4. List the name and complete street address of all persons conducting business under the above Assumed Name, OR if
an entity, provide the legal corporate, LLC, or Limited Partnership name and registered office address: (Required)
Attach additional sheet(s) if necessary. (A PO Box by itself is not acceptable)

Name Street City State Zip

Name Street City State Zip

Name Street City State Zip

5. This certificate is an amendment of Certificate of Assumed Name File Number:

6. I, the undersigned, certify that I am signing this document as the person whose signature is required, or as agent of the person(s)
whose signature would be required who has authorized me to sign this document on his/her behalf, or in both capacities. I further
certify that I have completed all required fields, and that the information in this document is true and correct and in compliance with
the applicable chapter of Minnesota Statutes. I understand that by signing this document I am subject to the penalties of perjury as set
forth in Section 609.48 as if I had signed this document under oath.

Signature Date
A signature of one Applicant listed or an Authorized Agent (The signing party must indicate on the document that they are acting as the agent of the person(s)
whose signature would be required and that they have been authorized to sign on behalf of that person(s).) is required.

Print Name and Title

Email Address for Official Notices

Check here to have your email address excluded from requests for bulk data, to the extent allowed by Minnesota law.

List a name and daytime phone number of a person who can be contacted about this form:

Contact Name Phone Number

Entities that own, lease, or have any financial interest in agricultural land or land capable of being farmed
must register with the MN Dept. of Agriculture’s Corporate Farm Program.

Does this entity own, lease, or have any financial interest in agricultural land or land capable of being farmed?
Yes No
Print Reset

AssumedNameAmendmentRev.05/31/2024
 INSTRUCTIONS

File your business document online by visiting our website at www.sos.mn.gov.

This form is intended merely as a guide for filing and is not intended to cover all situations. Retain the original signed
copy of this document for your records and submit a legible photocopy for filing with the Office of the Secretary of State.

If any of the information on the most recently filed Certificate or Amended Certificate of Assumed Name changes, you
must file this Amended Certificate within 60 days and publish after filing for two consecutive issues in the legal notices
section of a qualified legal newspaper in the county where the principal place of business is located. The newspaper will
return an affidavit of publication. A copy of the published notice should be kept by the Assumed Name Applicant with
the Certificate of Assumed Name. Failure to publish may render the Certificate of Amended Assumed Name Invalid.

1. List the exact business name (new name if changing). Only one business name may be filed per form. Assumed names
that duplicate corporate, limited partnership, limited liability partnership, limited liability company names or trademarks
already on file cannot be accepted for filing. A preliminary name availability check may be done by accessing our website
at www.sos.mn.gov. Note: You may only use corporate or other business entity designations if the business owner is a
corporation or other business entity already entitled to use that designation.
2. Provide a complete street address or rural route and rural route box number of the principal place of business. A
Minnesota address is preferable whenever available, but an out of state address is acceptable. A post office box cannot be
accepted as the address of the principal place of business.
3. List a Mailing Address if you cannot receive mail at the principal place of business address.
4. List name and complete street address of all persons conducting business under the assumed name. If the business
owner is a business organization such as a corporation, limited liability company, or limited partnership doing business
under an assumed name, the legal name and registered office address is required. (A PO Box by itself is not acceptable).
5. List the original Certificate of Assumed Name number, the date on which the original was filed and, if you are changing
the name in item 1, the original name.
6. A signature of one Applicant listed in #4 or an Authorized Agent (The signing party must indicate on the document
that they are acting as the agent of the person(s) whose signature would be required and that they have been
authorized to sign on behalf of that person(s).) is required. Include the date, printed name of the person signing, and the
title of the signer.
Email Address for Official Notices. This email address may be used to send annual renewal reminders and other
important notices that may require action or response. Check the box if you wish to have your email address excluded
from requests for bulk data, to the extent allowed by Minnesota law.
List a name and daytime telephone number of a person who can be contacted about this form.
Filing Fee: $50 for expedited service in-person and online filings, $30 if submitted by mail
Payable to the MN Secretary of State

Please submit all items together and mail to the address below:
FILE IN-PERSON OR MAIL TO:
Minnesota Secretary of State - Business Services
First National Bank Building
332 Minnesota Street, Suite N201
Saint Paul, MN 55101
(Staffed 8 a.m. – 4 p.m., Monday - Friday, excluding holidays)
Phone Lines: (9 a.m. - 4 p.m., M-F) Metro Area 651-296-2803; Greater MN 1-877-551-6767
All of the information on this form is public. Minnesota law requires certain information to be provided for this type of
filing. If that information is not included, your document may be returned unfiled. This document can be made available
in alternative formats, such as large print, Braille or audio tape, by calling (651)296-2803/voice. For a TTY/TTD (deaf
and hard of hearing) communication, contact the Minnesota Relay Service at 1-800-627-3529 and ask them to place a
call to (651)296-2803. The Secretary of State's Office does not discriminate on the basis of race, creed, color, sex, sexual
orientation, national origin, age, marital status, disability, religion, reliance on public assistance or political opinions or
affiliations in employment or the provision of service.