Wayne Certified Business Application

New Registration

Registration Renewal

NAME UNDER WHICH BUSINESS OR PROFESSIONAL SERVICES IS OR WILL BE CONDUCTED: * {{GeneralInvalidMessage}}

Principal Address: * {{InvalidAddressMesssage}}

City: * {{CityErrorMessage}}

State: *

Zip Code: * {{ZipCodeErrorMessage}}

Corporation Type: *

Registrants

LIST THE NAME AND COMPLETE ADDRESS OF ALL THE PERSONS CONDUCTING BUSINESS UNDER THE ABOVE ASSUMED NAME. ADDRESS INFORMATION IS REQUIRED FOR ALL LISTED REGISTRANTS.

Last Name/Business Name: {{GeneralInvalidMessage}}

First Name: {{GeneralInvalidMessage}}

Middle Name: {{GeneralInvalidMessage}}

Address: * {{InvalidAddressMesssage}}

City: * {{CityErrorMessage}}

State: *

Zip Code: * {{ZipCodeErrorMessage}}

Last Name/Business Name: {{GeneralInvalidMessage}}

First Name: {{GeneralInvalidMessage}}

Middle Name: {{GeneralInvalidMessage}}

Address: * {{InvalidAddressMesssage}}

City: * {{CityErrorMessage}}

State: *

Zip Code: * {{ZipCodeErrorMessage}}

Last Name/Business Name: {{GeneralInvalidMessage}}

First Name: {{GeneralInvalidMessage}}

Middle Name: {{GeneralInvalidMessage}}

Address: * {{InvalidAddressMesssage}}

City: * {{CityErrorMessage}}

State: *

Zip Code: * {{ZipCodeErrorMessage}}

Last Name/Business Name: {{GeneralInvalidMessage}}

First Name: {{GeneralInvalidMessage}}

Middle Name: {{GeneralInvalidMessage}}

Address: * {{InvalidAddressMesssage}}

City: * {{CityErrorMessage}}

State: *

Zip Code: * {{ZipCodeErrorMessage}}

Last Name/Business Name: {{GeneralInvalidMessage}}

First Name: {{GeneralInvalidMessage}}

Middle Name: {{GeneralInvalidMessage}}

Address: * {{InvalidAddressMesssage}}

City: * {{CityErrorMessage}}

State: *

Zip Code: * {{ZipCodeErrorMessage}}

The DBA on-line application is provided as a convenience for Internet users. We do not provide technical assistance in the use of the Internet. If you experience problems in completing the application and/or DO NOT receive a confirmation number after submitting, you must come into the County Clerk's office to file your DBA. If you successfully complete your application and RECEIVE A CONFIRMATION NUMBER you must still come into our office to obtain your filing.

Thank you for using the online service. Your reference number is: {{FilingID}}

Please Note: You must come into the Wayne County Clerk's office to sign and pay your fee, to ensure the filing of this document. Assumed Name web submissions must be Recorded within 72 hours or it will be removed from the queue.

For locations and hours, please visit https://www.waynecounty.com/elected/clerk/contact-us.aspx.

Assumed Name Pre-Registration

Application

Registrants

Disclaimer and Submission

Confirmation