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 consumers 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) Catering Rochester by Karen
2. Principal Place of Business: (Required) 19684 34th St NE, St. Charles, MN 55972
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: Tilly's Tavern Inc. 19684 34th St NE, St. Charles, MN 55972
4. 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.
Signature: Karen Lowe-Connelly
EMAIL FOR OFFICIAL NOTICES:
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:
Karen Lowe-Connelly 507-273-0603
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.