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ASSUMED NAME RECORD <br />CERTIFICATE OF OWNERSHIP FOR UNINCORPORATED BUSINESS OR PROFESSION <br />Notice: "Certificates of Ownership" are valid only for a period not to exceed 10 years from the <br />data filed in the County Clerk's Office. <br />(Chapter 36 Section I Title 4 -Business and Commerce Code) <br />This certificate, properly executed, is to be filed immediately with the County Clerk, <br />NAME IN WHICH BUSINESS IS IN OR WILL BE CONDUCTED <br />J61antlah Beck <br />BUSINESS ADDRESS: 8983 CR 451 <br />CITY: KJrbyville STATE: TX ZIP CODE: 75956 <br />PERIOD (not to exceed 10yyears DURING WHICH ASSUMED NAME WILL BE USED: <br />613/2014 - 6/31224 <br />BUSINESS IS TO BE CONDUCTED AS (Please Check One): Sole Proprietorship 0 Joint Venture <br />0 General Partnership O Limited Partnership O Joint Stock Co. 0 Real Estate Investment Trust <br />0 Other (Name Type) <br />CERTIFICATE OF OWNERSHIP <br />l/We, the undersigned, are the owner_ of the above business and my/our name and address_ given is/are hue <br />and correct, and there istam no ownerships) in said business other than those listed herein below. <br />• NAMES OF OWNERS e <br />NAME Jeremiah Back SIGNATURE`—�.y,/.y�"� <br />Residents Address 8983 CR 451 <br />City x1dryville State TX yip Code 75 <br />NAM8 SIGNATURE <br />Residence Address <br />City State Zip Codc <br />NAME SIGNATURE <br />Residence Address <br />City State Zip Code <br />SIGNATURE <br />Residence Address <br />City State Zip Code <br />THE STATE OF <br />Wa- <br />COUNTYOF <br />This Assumed Name was acknowledged before me on <br />Date of:lc ow tdgmroaQ <br />to, <br />MARGARET A. COLLIER <br />story Public. State of Texas <br />My Commission Expires <br />May 08. 2017 <br />