The Assumed Name Certificate of Intention



            Fill in the top paragraph, please fill in the name of business (be sure to include capital letters and symbols where they apply),

address of the business, the name(s) and address(es) of all the owners of the business.  Fill in the date on the top portion of the certificate

at the time of signing before a Notary.  The names of the owner(s) in the upper portion should be printed or typed on this portion of the Certificate.


All person(s) who are owning, conducting or transacting the business should sign their name(s) in front of a Notary Public on the

bottom portion.  The Notary Public should date the bottom half of the form, sign and stamp the Notary seal.


            Return the Certificate of Intention, together with a check in the amount of $5.00 made payable to the Ford County Clerk. 

Mail to the Ford County Clerk’s Office, 200 W. State St., Room 101, Paxton, IL. 60957.



           Upon receipt of the executed Certificate of Intention, we will check the index to make sure this name is not already being used. 

We will then prepare the Assumed Name Publication Notice.  This Publication Notice will be sent to you with instructions.



(There are no other fees after the initial $5.00 fee)


Click here to print Assumed Name Application (PDF)