
INDEX No.
Certificate
of
CONDUCTING BUSINESS UNDER
THE NAME OF
State of New York
ss.:
County of
On before me, the undersigned,
personally appeared
personally known to me or proved to me on the basis of satisfac-
tory evidence to be the individual(s) whose name(s) is (are) sub-
scribed to the within instrument and acknowledged to me that he/
she/they executed the same in his/her/their capacity(ies), and that
by his/her/their signature(s) on the instrument, the individual(s), or
the person upon behalf of which the individual(s) acted, executed
the instrument.
(signature and office of individual taking acknowledgment)
State of
ss.:
County of
On before me, the undersigned,
personally appeared
personally known to me or proved to me on the basis of satis-
factory evidence to be the individual(s) whose name(s) is (are)
subscribed to the within instrument and acknowledged to me
that he/she/they executed the same in his/her/their capacity(ies),
and that by his/her/their signature(s) on the instrument, the
individual(s), or the person upon behalf of which the individual(s)
acted, executed the instrument.
(signature and office of individual taking acknowledgment)
GBL §130.4. A certified copy of the original certificate, or if an amended certificate has been filed, then of the most
recent amended certificate filed shall be conspicuously displayed on the premises at each place in which the business for
which the same was filed is conducted.
Some counties request the type of business.
Consultant Services Medical—Home Care Services
Educational Services Professional—Technical Services
Entertainment–Recreation Real Estate Services
Finance–Insurance Services Retail Trade
Home Improvement Services Wholesale Trade
Other (state type)