STATE OF MAINE

CERTIFICATE OF SOLE PROPRIETOR or PARTNERSHIPS ADOPTING NAME OTHER THAN
 HIS OR HER OWN
PURSUANT TO Title 31 Chapter1, §2

	The undersigned hereby certifies that he or she intends to engage in the _________________ 
business as sole proprietor thereof, and to adopt the name style and designation ________________
______________________________________ in the conduct of said business.

NAME  __________________________________________________________________________

RESIDENCE  _____________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

STATE OF MAINE
______

________________, ss							_________________, 19__

	Then personally appeared ____________________________________ and made oath to the foregoing certificate, that the same is true.
Before me,____________________________

						
City/Town Clerk				

Clerk’s Office Municipality of
						
Received ____________________, 20____
at _______________ H.___ M. ____ M. and
recorded in Book ______ Page __________
Attest:

                          Clerk

*  This form must be completed by sole proprietors or partnerships, and by the city or town clerk in the municipality
in which the sole proprietorship is located: see Title 31 Chapter1, §2