Assumed Business Name (DBA) Application

Assumed Business Name (DBA) Application
Apply to register your business under an assumed name. Please provide accurate information for processing your application.
Applicant Full Name
First NameLast Name
Applicant Email Address
example@example.com
Applicant Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Applicant Mailing Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Proposed Business Name (DBA)
Business Physical Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Type of Business Structure
Describe the Nature of Your Business Activities
Names of Business Owners/Partners
Date Business Will Begin Operating Under This Name
MonthDayYear
Date
Has this business name been registered before?
Upload Supporting Documents (if required by your jurisdiction)
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Applicant Signature
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