A. The certificate of assumed or fictitious name shall be on a form prescribed by the Commission that sets forth the following:
1. The name of the person who will be conducting business under the assumed or fictitious name;
3. Whether the person who will be conducting business under the assumed or fictitious name is an individual or, if not, the type of legal or commercial entity of the person;
4. If the person who will be conducting business under the assumed or fictitious name is an individual, the post office address of the individual’s office or residence, which shall include a street address, city or town, state, and zip code;
5. If the person who will be conducting business under the assumed or fictitious name is a domestic or foreign corporation, limited liability company, business trust, or limited partnership authorized by the Commission to transact business in the Commonwealth, the identification number issued by the Commission to the person;
6. If the person who will be conducting business under the assumed or fictitious name is a domestic or foreign partnership that has filed with the Commission a statement of partnership authority or a statement of registration as a registered limited liability partnership that has not been canceled, the identification number issued by the Commission to the partnership;
7. If the person who will be conducting business under the assumed or fictitious name is not subject to subdivision 4, 5, or 6, the post office address of the person’s principal place of business, which shall include a street address, city or town, state, and zip code; and
8. The printed name and title of the individual signing the certificate of assumed or fictitious name.
B. The certificate of assumed or fictitious name shall be signed by (i) the individual who will be conducting business under the assumed or fictitious name or (ii) an authorized representative of the person who will be conducting business under the assumed or fictitious name when the person is not an individual.
C. The clerk of the Commission shall charge a fee of $10 for the filing of a certificate of assumed or fictitious name.