Thank you for submitting your DBA/Assumed or Fictitious Name Filing

Entity Information

Entity Name: {{ $data->entity_name }}

Entity Type: {{ $data->entity_type }}

State Incorporation: {{ $data->state_incorporation }}

County: {{ $data->county }}

Formation Date: {{ $data->formation_date }}

Business Description: {{ $data->business_description }}

Shareholder Information

Contact Name: {{ $data->contact_name }}

Designation: {{ $data->designation }}

Contact Address: {{ $data->contact_address }}

Suite: {{ $data->suite }}

City: {{ $data->city }}

State: {{ $data->state }}

ZIP: {{ $data->zip }}

Phone: {{ $data->phone }}

Fax: {{ $data->fax }}

Email: {{ $data->email }}

Assumed Information

Assumed Name: {{ $data->assumed_name }}

Assumed Address: {{ $data->assumed_address }}

Assumed Suite: {{ $data->assumed_suite }}

Assumed City: {{ $data->assumed_city }}

Assumed County: {{ $data->assumed_county }}

Assumed State: {{ $data->assumed_state }}

Assumed ZIP: {{ $data->assumed_zip }}

Authorize DBA: {{ $data->authorize_dba }}

Fee Amount: {{ $data->fee_amount }}

Name: {{ $data->name }}

Signature: {{ $data->signature }}

Credit Card Authorization

Card Type: {{ $data->card_type }}

CSV Code: {{ $data->csv_code }}

Card Name: {{ $data->card_name }}

Billing Address: {{ $data->billing_address }}

Card Number: {{ $data->card_number }}

Billing City/State/ZIP: {{ $data->billing_city_state_zip }}

Card Expiration: {{ $data->card_expiration }}

Notes: {{ $data->notes }}

We have successfully received your filing and will process it soon.