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Office of the Minnesota Secretary State

Certificate of Assumed Name - Avera Medical Group Ivanhoe

June 20, 2013
Marshall Independent

June 21, 22 , 2013

Office of the Minnesota Secretary State

Assumed Name

Certificate of

Assumed Name

Minnesota Statutes, Chapter 333

The filing of an assumed name does not provide a user with exclusive rights to that name. The filing is required for consumer protection in order to enable consumers to be able to identify the true owner of a business.

1. List the exact name under which the business is or will be conducted: Avera Medical Group Ivanhoe

2. Principal Place of Business: (Required) 312 E George Street Ivanhoe MN 56142

3. List the names and complete street address of all persons conducting business under the above Assumed Name, OR if an entity, provide the legal corporate, LLC, or Limited Partnership name and registered office address: (Required). Attach additional sheets(s) if necessary. Avera Marshall 300 S Bruce Street Marshall MN 56258

4. I, the undersigned, certify that I am signing this document as the person whose signature is required, or as agent of the person(s) whose signature would be required who has authorized me to sign this document on his/ her behalf, or in both capacities. I further certify that I have completed all required fields, and that the information in this document is true and correct and in compliance with the applicable chapter of Minnesota Statutes. I understand that by signing this document I am subject to the penalties of perjury as set forth in Section 609.48 as if I had signed this document under oath.

Mary Maertens,

President & CEO 5/15/2013

Contact Person

Deb Burckhardt




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