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home : legals : assumed names July 24, 2014

2/22/2013 3:28:00 PM
Office of the Minnesota Secretary of State Assumed Name|Ammendment to Assumed Name Minnesota Statutes, 333 Back to Health Chiropractic Clinic

Office of the Minnesota

Secretary of State

Assumed Name|Ammendment to Assumed Name

Minnesota Statutes, 333

The filing of an assumed name does not provide a user with exclusive rights to that name. The filing is required for consumer protection in order to enable customers to be able to identify the true owner of a business.

1. List the exact assumed name under which the business is or will be conducted: (Required) Back to Health Chiropractic Clinic

2. Principal Place of Business: (Required) 5231 East Frontage Road Hwy 52 N STE 201-202, Rochester, MN, 55901

3. List the name and complete street address of all persons conducting business under the above Assumed Name, OR if an entity, provide the legal corporate, LLC, or Limited Partnership name and registered office address: (Required)

Name: Back to Health Chiropractic Clinic, P.A.

Address: 5231 East Frontage Road Hwy 52 N STE 201-202, Rochester, MN, 55901

4. This certificate is an amendment of Certificate of Assumed Name File Number: 128701 Originally filed on: 03/04/1993

Under the name (list the previous name only if you are amending that name):_________________

5. I, the undersigned, certify that I am signing this document as the person whose signature is required, or as agent of the person(s) whose signature would be required who has authorized me to sign this document on his/her

behalf, or in both capacities. I further certify that I have completed all required fields, and that the information in this document is true and correct and in compliance with the applicable chapter of Minnesota Statutes. I understand that by signing this document I am subject to the penalties of perjury as set forth in Section 609.48 as if I had signed this document under oath.

/s/ Roger A. Marquardt 1/24/13

Signature (ONLY one person listed in #3 or an authorized agent is required to sign)

ROGER A. MARQUARDT DOCTOR OF CHIROPRACTIC/CEO

Print Name and Title

Email Address for offical notices: DRRMARQUARDT@AOL.COM

a Check here to have your email address excluded from requests for bulk data, to the extent allowed by Minnesota law.

List a name and daytime phone number of a person who can be contacted about this form:

SHARI (507) 280-6186

Entities that own, lease, or have any financial interest in agricultural land or land capable of being farmed must register with the MN Dept. of Agriculture's Corporate Farm Program.

Does this entity own, lease, or have any financial interest in agricultural land or land capable of being farmed?

Yes _ No a

STATE OF MINNESOTA

DEPARTMENT OF STATE

FILED

FEB 04 2013

Mark Ritchie

Secretary of State


Claremont Service




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