ASSUMED BUSINESS NAME:   Enter the name. Do not include the person or business who will be “Doing Business As” this name. It must be written in the alphabet used to write the English language and may include Arabic and Roman numerals and incidental punctuation marks.
NOTE:  The registration of a name does not grant exclusive rights to that name. A name may be available for registration, but another person may have a prior legal right to the name or a very similar one. If the name is similar to another well-known name, it could be a cause for legal action.

DESCRIPTION OF BUSINESS:  A brief description of the business activity.

PRINCIPAL PLACE OF BUSINESS:   Physical address where the business is located. This address may also be where the business records are kept. The principal office may not be a PO Box, a commercial mail receiving agency, a mail forwarding business, or a virtual office.

WHO IS AUTHORIZED TO REPRESENT THE OWNERS:  The individual or business who is authorized to represent the owner(s), and will receive mailed notices.

MAILING ADDRESS OF AUTHORIZED REPRESENTATIVE:  An address where renewal notices will be mailed. Other types of mail will also be delivered to this publicly available address.

NAMES OF OWNERS (REGISTRANTS) AND PUBLICLY AVAILABLE ADDRESSES:  The name(s) of the individual(s) or business entity(ies) who will own and do business as the Assumed Business Name. The physical address may not be a PO Box, a commercial mail receiving agency, a mail forwarding business, or a virtual office.

COUNTIES:  Select the counties in which the name should be registered.  This will keep others from registering the same name in those Oregon counties. 

EXECUTION/SIGNATURE(S):  (All owners/registrants must sign.)  This legal declaration must be signed.​​​​