Assumed Business Name: Intake Form

Please submit the following information via this online form, which is encrypted with SSL to help ensure the data you enter is secure.

Name*
Prefix First Middle Last Suffix
Email*
Enter Email Confirm Email
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Information
Initial Filing or Renewal*
Do you need to file for a new assumed name (dba), or do you need to renew your assumed name?
- I would like to file for an assumed name.
- I would like to renew my assumed name filing.
Business Name*
Please include the full legal business name including punctuation and the entity suffix (LLC, Inc., etc.).
If the business is a sole proprietorship please list the sole proprietor's name.
Business DBA ("Assumed Name")*
Business Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your Business Title(s)
Examples: President, CEO, Director, Member, etc.
Additional Information
Please include any additional information you would like our attorneys to know.
Disclaimer*
Our attorneys may review the information you submit for the purposes described on this website. The use of this form for communication with our firm does not establish an attorney-client relationship. Our review of the information sent to us will not preclude us from representing any other client if confidential information is sent through this form.
- I agree
- I do not agree
Email
This field is for validation purposes and should be left unchanged.

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Business Information