APPLICATION RE PRICKLY PEDAL TRADE NAME.PDF

State of Arizona – Office of the Secretary of State DO NOT WRITE IN THIS SPACE
Trade Name Registration Application
SEND BY MAIL TO:
Secretary of State Michele Reagan, Atten: Trade Name/Trademark Division
1700 W. Washington Street, FL. 7, Phoenix, AZ 85007-2808
OR return this application in person:
PHOENIX - State Capitol Executive Tower, TUCSON - Arizona State Complex,
1700 W. Washington Street, 1st Fl., Room 103 400 W. Congress, 1st Fl., Suite 141
Office Hours: Monday through Friday, 8 a.m. to 5 p.m., except state holidays.
PLEASE NOTE: The registration of a Trade Name is not legally required in Arizona,
but is an accepted business practice. The registration is a public record and does not FOR OFFICE USE ONLY
constitute exclusive rights to the holder of the Trade Name. SOSBSTN REV. 1/5/2015
APPLICANT INSTRUCTIONS
First time applicants shall use this form to apply for a Trade Name under Be Accurate: Complete all applicable fields on this form. Write legibly; or
A.R.S. § 44-1460. Applicants must be at least 18. This application must be fill out this application online at www.azsos.gov and print it.
signed, dated and notarized. Filing Fee and Payment: $10; expedited service, include an additional
Trademark/Renewal/Address Change: To register a Trademark, DO NOT $25. Checks or money orders shall be made payable to the Secretary of
use this form. Use the Trademark Registration Application. To renew a State. Credit cards are not accepted.
Trade Name, use the Trade Name Renewal form. To report a change of Questions? Call (602) 542-6187; in-state/toll-free (800) 458-5842.
address use the Trade Name Amendment form. Website: All forms are available on the Secretary of State’s Website,
Processing: 2-3 weeks; expedited service (24-48 hours) available. www.azsos.gov.
1. Name, title or designation to be registered SPACE BELOW FOR OFFICE USE ONLY - VALIDATION AREA
Trade Name (Names with a corporate ending are unacceptable. Examples: Inc., LLC. or Ltd.)
Prickly Pedal
The date which the name above was first used by the applicant Month Day Year
in Arizona. This date must be today or prior to today’s date. 03 18 14
2. Entity Type and Owner Name
What type of person or entity functions as the owner of this trade name? Enter the entity or person(s) name. CHOOSE ONLY ONE.
A.  SOLE PROPRIETORSHIP (one person) B.  ASSOCIATION C.  ORGANIZATION
Applicant First and Last Name Association Name Organization Name
D.  PARTNERSHIP [List name(s)]
Either provide the partnership name(s) OR multiple individuals by the Applicants’ First and Last Name
E.  CORPORATION * F.  LIMITED LIABILITY COMPANY (LLC) *
Corporation Name Limited Liability Company Name
*Corporation/LLC: If checked the applicant must be on the Arizona Corporation Commission’s website as a member/officer. The application will be returned if not incorporated.
G.  FOREIGN CORPORATION Licensed to do business in Arizona H.  OTHER (If other, please indicate type. Examples: firm, society, foundation, federation)
Foreign Corporation Name Other Name
Government Agency (Maricopa County)
3. Nature of Business
General nature of business conducted
Parks and Recreation
4. Contact Information Addresses must be complete as they are used to mail certificates and renewal notices.
Mailing Address Apt., Space, Suite, or Floor #
C/O Maricopa County Parks & Recreation Dept. 41835 N. Castle Hot Springs Road
City State Zip Code Business Phone Number
Morristown AZ 85342 ( 602 ) 506-2930
5. Applicant’s Signature ~ If two applicants are listed in Section 2D, both must sign.
1st Signer’s Printed Name 2nd Signer’s Printed Name (if applicable)
Maricopa County Board of Supervisors Chairman Steve Chucri
1st Signer’s Signature Date 2nd Signer’s Signature Date
State of Arizona ) State of Arizona )
County of ___________________ ) County of ___________________ )
On this ______ day of ________________________, 20 ____ On this ______ day of ________________________, 20 ____
__________________________________________________ __________________________________________________
(Name of Person Appearing Before the Notary) (Name of Person Appearing Before the Notary)
personally appeared before me and acknowledged that he/she personally appeared before me and acknowledged that he/she
signed this document for it’s stated purpose. signed this document for it’s stated purpose.
Print Form Reset Form ___________________________ ___________________________
(Notary Public) (Notary Public)