Certificate of Adoption of Trade Name form (PDF)

CERTIFICATE OF ADOPTION OF TRADE NAME 
To be filed with the Town Clerk of Waterford 
 
Note: Required by Sec 35-1 of the Connecticut General Statutes, a Trade Name is 
filed with the Town Clerk for purposes of identifying those persons doing business 
under a fictitious Trade Name, i.e, for consumer protection purposes. This 
certificate does not protect that name from use by someone else. 
                                  The penalty for failure to file a Trade Name Certificate is  $500.00. 
 
The undersigned is (are) conducting and transacting business in the said TOWN OF WATERFORD under the 
full name of: 
 
 
Under the assumed name: _________________________________________________________________________________ 
Type of Business: __________________________________________________________________________________________ 
The location of the business is:   
 
 
Phone #  
 
 
The full name of every person conducting or transacting said business, together with the post office address of 
each said person is as follows (please print): 
 
Name(s) 
Mailing Address 
 
 
 
 
 
 
 
 
 
Corresponding Signature(s) 
 
DO NOT sign at right until 
  
 
in the presence of a Notary 
  
            
or the Town Clerk 
  
 
 
Zoning Requirements: The location and operation of any business is subject to  the  zoning  
regulations of the Town of Waterford. The filing of a Trade Name Certificate DOES NOT create a right 
to operate the business. Any individual transacting business in  the  Town  of  Waterford  is 
responsible for  ensuring  compliance with the zoning regulations.  Contact the Zoning Department  
for specific information on the requirements as they pertain to your business. 
 
 
State of Connecticut 
County of New London 
ss. Waterford 
  
 
Date 
Personally appeared,   
 
who subscribed and swore to the truth of the foregoing certificate and acknowledged that he/she 
executed the same, before me. 
 
 
 
Notary or Town Clerk 
 
SIGN