Advanced Entity Formation System

To place an order for Assumed Business Name / DBA, please complete and submit the following worksheet. Prices are as follows:

            ABN/DBA Service - $165.00 ($240.00 for Borroughs)

* This fee is an estimate only. It is possible to incur additional disbursements in order to complete this order. If so the additional fees will be charged to the credit card provided for payment.

** IF Consents from State Agencies are necessary, add another $30 per consent attempt (in addition to any disbursement assessed by the agency)

In order to keep your credit card transaction secure, please contact our Corporate Department at: 518-465-8951 or Toll Free 800-640-7863 and supply us with your credit card information. If not paying by credit card, send Certified or Attorney Check with the applicable fee to:

Attorneys Process & Research Service Inc.
283 Washington Ave.
Albany, N. Y. 12206

Legal Name of Entity:


Assumed Name to be Filed:


Physical Address Where Assumed Name Will be Used:

County *

Address *

Principal Address of Business:

Address *

Any Additional Counties to Be Included:


Name and Title of Person Authorized to Execute Document on Behalf of Entity:


Email Address *

How would you like to be contacted
Email	Phone	Fax

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Please make sure all required fields (denoted with a *) are filled in before submission