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Assumed Name (11-16)

Office of the Minnesota Secretary of State
Assumed Name/Certificate of Assumed Name
Minnesota Statutes, Chapter 333

    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.
    1. List the exact assumed name under which the business is or will be conducted.
    Lake Bronson Market
    2. Principal Place of Business
    104 East Main Street
    Lake Bronson, MN 56734
    3. 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).
    Patricia Jane Nerguson
    217 S. 4th Ave.
    Lake Bronson, MN 56734
    4. 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 m subject to the penalties of perjury as set forth in Section 609.48 as if I had signed this document under oath.
    Dated: 9/22/2011
    (Signed) Patricia J. Nerguson (Name Holder)

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