For Use by Domestic and Foreign, for Profit and Nonprofit Corporations

Certificate of

Registration of Alternate Name

(For Use by Domestic and Foreign, For Profit and Nonprofit Corporations)

Check appropriate statute:

Title 14A:2-2. 1(2) New Jersey Business Corporation Act (File in Duplicate)

Title 1 5A:2-3(b) New Jersey Nonprofit Corporation Act (File in Triplicate)

Pursuant to the provisions of the appropriate Statute, checked above, the undersigned corporation hereby applies for the registration of an alternate name in New Jersey for a period of five (5) years, and for that purpose submits the following application:

1. Name of Corporation
2. State where incorporated
3. Date of incorporation

Date of authorization to transact business in New Jersey (Foreign Corporation only)

1. Alternate name to be used
2. The character or nature of the particular business/activity to be conducted using the alternate name is:
3. The Corporation intends to use the alternate name in this State.

7. The Corporation has not previously used the alternate name in this State in violation of the applicable Statute, or, if it has, the month and year in which it commenced such use is

Signature ______

Name

Title (Must be CH. Of Bd. Pres. or Vice Pres.)

Date

THE PURPOSE OF THIS FORM IS TO SIMPLIFY THE FILING REQUIREMENTS OF THE TREASURER OF THE STATE OF NEW JERSEY AND DOES NOT REPLACE THE NEED FOR COMPETENT LEGAL ADVICE.

Instructions: Type all information except signatures.

Form must be completed and filed in duplicate.

The original document will be retained by the Division of Commercial Recording.

Remittance:Check or Money Order should be signed and made payable to the Secretary of State, and be
submitted with the document to be filed.

Filing Fee: Contact Secretary of State’s Office

Address:Regular Service (by regular mail)Expedited Service (by messenger
or in person)

Department of StateDepartment of State

Division of Commercial RecordingDivision of Commercial Recording

P.O. Box 308820 Bear Tavern Rd., 2nd Floor

Trenton, NJ 08625Trenton, NJ 08628

Expedited Service requests must be delivered in person or by messenger service such as Federal Express, Emery, UPS, or any overnight service, but not U.S. Postal Service Overnight because it does not directly deliver to our division office.

Please use zip code 08625 for regular mail. Regular mail wrongly addressed to the “Expedited Service” zip code 08628 will be returned “undeliverable” by the local Post Office.

Information on Registration of Alternate Name
(For Use by Domestic Profit and Foreign Corporations)
Title 14A:2-2.1(2) New Jersey Business Corporation Act
Title 15A:2-3(b) New Jersey Nonprofit Corporation Act

1. NAME OF CORPORATION: State current name of corporation.
2. STATE WHERE INCORPORATED: Provide domestic state of incorporation.
3. DATE OF INCORPORATION: Date of original filing in the home state. Date of authorization to transact business in New Jersey (foreign corporation only): if applicable, provide date of original filing in New Jersey.
4. ALTERNATE NAME TO BE USED: State alternate name.
5. CHARACTER OR NATURE OF THE PARTICULAR BUSINESS/ACTIVITY TO BE CONDUCTED USING THE ALTERNATE NAME: Corporation must provide a brief statement of the character or nature of the particular business or businesses to be conducted using the alternate name.
6. NO INFORMATION REQUIRED.
7. PREVIOUS USE: If alternate name has been previously used prior to registering, give month/year corporation commenced such use.