All DBA Updates must be made to the City Clerk Department prior to the change being made. For all other types of changes, contact the City Clerk Department at cityclerk@cityblm.org.

Legal Entity Name

Current DBA (Doing Business As) Name

Requested DBA (Doing Business As) Name

Proof of Assumed Name Change with the State of IL

Click Here to Upload

Title of Authorized Agent

Signature of Authorized Agent

First Name

Last Name

Choose how to sign

Draw Type

By signing, you acknowledge or affirm that 1. You are authorized to sign as an owner, officer, or authorized agent, of the above-listed business; and 2. You declare that all the information included in this application, and any attachment hereto, is true and accurate to the best of your information, knowledge, and belief.