Statement of Abandonment of an Assumed Name (Texas)
This form registers the abandonment of the assumed name of a corporation, limited liability company, or limited partnership in Texas. The form provided here is simply a sample of what the actual Form 504 looks like.
Office of the Secretary of State
Corporations Section
P.O. Box 13697
Austin, Texas 78711-3697
STATEMENT OF ABANDONMENT OF ASSUMED NAME
1. The name of the corporation, limited liability company, limited partnership, or registered limited liability partnership is _________________________
and the file number, if any, assigned by the secretary of state is _________________________
2. The assumed name being abandoned is _________________________
3. The assumed name certificate was filed in the office of the secretary of state on _________________________;
an assumed name certificate also has been filed in the office of the county clerk in the following county or counties: _________________________
4. If the entity is required to maintain a registered office in Texas, the address of the registered office is and the name of its registered agent at such address is _________________________
The address of the principal office, if not the same as the registered office, is _________________________
5. If the entity is not required to or does not maintain a registered office in Texas, the office address in Texas is _________________________
If the entity is not incorporated, organized, or associated under the laws of Texas, the address of its place of business in Texas is _________________________
and its office address elsewhere, if any is _________________________
6. The undersigned, if acting in the capacity of an attorney-in-fact of the entity, certifies that the entity has duly authorized the attorney-in-fact in writing to execute this document.
______________________________ Signature of officer, general partner, manager, representative or attorney-in-fact of the entity
NOTE
This form is designed to meet statutory requirements for filing with the secretary of state and is not designed to meet filing requirements on the county level. Filing requirements for assumed name documents to be filed with the county clerk differ. Assumed name documents filed with the county clerk are to be executed and acknowledged by the filing party, which requires that the document be notarized.
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INSTRUCTIONS FOR FILLING OUT THIS FORM
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1. A registrant that ceases to transact business or render professional services under an assumed name for which a certificate has been filed may utilize this form for purposes of filing an abandonment of use pursuant to the Texas Business & Commerce Code, section 36.14. The name of the corporation, limited liability company, limited partnership or registered limited liability partnership in item 1 of the statement should be the name of the entity as it is stated in its articles of incorporation, articles of organization, certificate of limited partnership, application for certificate of, or comparable document.
2. The statement should be signed by an officer, manager, general partner, representative or attorney in fact of the entity. Prior to signing, please review carefully the statements set forth in the document. A person commits an offense under section 36.27 of the Business & Commerce Code if the person signs a document the person knows is false in any material respect with the intent that the document be delivered to the secretary of state for filing. The offense is punishable as if it were an offense under section 37.10 of the Penal Code. This form is designed to meet minimum statutory filing requirements; no warranty is made regarding the suitability of this form for any particular purpose. This form and the information provided are not substitutes for the advice of an attorney.
3. The filing fee is $10. Send the executed certificate together with the filing fee to the Secretary of State, Statutory Filings Division, Corporations Section, P.O. Box 13697, Austin, Texas 78711-3697. The delivery address is 1019 Brazos, Austin, Texas 78701. The telephone number is (512) 463-5555, TDD: (800) 735-2989, FAX: (512) 463-5709.
4. Upon filing, the certificate will be placed on record. If a duplicate file-stamped copy is desired, you must submit a duplicate copy of the document for this purpose.
5. The information provided in paragraph 3 regarding the registered agent and registered office address in Texas must match the information on file in this office. To verify the information on file, you may contact our Public Information Team at (512) 463-5555 or e-mail at [email protected].
6. Personal checks and MasterCard®, Visa®, and Discover® are accepted in payment of the filing fee. Fees paid by credit card are subject to a statutorily authorized processing cost of 2.1% of the total fees. A check or money order must be made payable to the secretary of state and be payable through a U.S. bank or other financial institution.
7. This form is designed to meet statutory requirements for filing with the secretary of state and is not designed for filing with the county clerk.. Assumed name documents filed with the county clerk are to be executed and acknowledged by the filing party, which requires that the document be notarized. All assumed name certificates to be filed with the county clerk must be sent directly to the appropriate county clerk and not to the secretary of state.