Fillable Fictitious Business Name Statement

INSTRUCTIONS FOR COMPLETION OF STATEMENT

Business and Professions Code Section 17913:

Where one asterisk appears in the form:

(a) Insert the fictitious business name or names

(b) Only those businesses operated at the same address and under the same ownership may be listed on one statement

Where two asterisks appear in the form:

(a) If the registrant has a place of business in this state, insert the street address and county of his or her principal place of

business in this state

(b) If the registrant has no place of business in this state, insert the street address and county of his or her principal place of

business outside this state and file with the Clerk of Sacramento County (B&P 17915)

(c) Mail Box and Post Office Box Numbers are not acceptable as a business address when used alone without a street address

***

Where three asterisks appear in the form:

(a) If the registrant is an individual, insert his or her full name and residence address

(b) If the registrants are husband and wife, insert the full name and residence address of both the husband and the wife

(c) If the registrant is a general partnership, copartnership, joint venture, limited liability partnership, or unincorporated

association other than a partnership, insert the full name and residence address of each general partner

(d) If the registrant is a limited partnership, insert the full name and residence address of each general partner

(e) If the registrant is a limited liability company, insert the name and address of the limited liability company, as set out in its

articles of organization on file with the CA Secretary of State, and the state of organization

(f)

If the registrant is a trust, insert the full name and residence address of each trustee

(g) If the registrant is a corporation, insert the name and address of the corporation, as set out in its articles of incorporation on file

with the CA Secretary of State, and the state of incorporation

(h) If the registrants are state or local registered domestic partners, insert the full name and residence address of each domestic

partner

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Where four asterisks appear in the form:

(a) Check whichever of the terms listed on the front of the form best describes the nature of the business

*****

Where five asterisks appear in the form:

(a) Insert the date on which the registrant first commenced to transact business under the fictitious business name or names listed, if

already transacting business under that name or names

(b) Insert N/A if you have not yet commenced to transact business under the fictitious business name or names listed

Business and Professions Code Section 17914

The statement shall be signed as follows:

(a) If the registrant is an individual, by the individual

(b) If the registrants are husband and wife, by the husband or wife

(c) If the registrant is a general partnership, limited partnership, limited liability partnership, copartnership, joint venture, or

unincorporated association other than a partnership, by a general partner

(d) If the registrant is a limited liability company, by a manager or officer

(e) If the registrant is a trust, by a trustee

(f)

If the registrant is a corporation, by an officer

(g) If the registrant is a state or local registered domestic partnership, by one of the domestic partners

Business and Professions Code Section 17915

The fictitious business name statement shall be filed with the clerk of the county in which the registrant has his or her principal place of

business in this state or, if the registrant has no place of business in this state, with the Clerk of Sacramento County. Nothing in this chapter

shall preclude a person from filing a fictitious business name statement in a county other than that where the principal place of business is

located, as long as the requirements of this subdivision are also met.

Business and Professions Code Section 17917

Publication for Original, New Filings (renewal with change in facts from previous filing), or Refile

(a) Within 30 days after a fictitious business name statement has been filed, the registrant shall cause it to be published in a

newspaper of general circulation in the county where the fictitious business name statement was filed or, if there is no such

newspaper in that county, in a newspaper of general circulation in an adjoining county. If the registrant does not have a place of

business in this state, the notice shall be published in a newspaper of general circulation in Sacramento County. The publication

must be once a week for four successive weeks and an affidavit of publication must be filed with the county clerk where the

fictitious business name statement was filed within 30 days after the completion of the publication.

(b) If a refilling is required because the prior statement has expired, the refiling need not be published, unless there has been a

change in the information required in the expired statement, provided the refiling is filed within 40 days of the date the statement

expired.

Business and Professions Code Section 17922

Abandonment of Fictitious Business Name

(a) Upon ceasing to transact business in this state under a fictitious business name that was filed in the previous five years, a person

who has filed a fictitious business name statement shall file a statement of abandonment of use of fictitious business name. The

statement shall be executed and published in the same manner as a fictitious business name statement and shall be filed with the

county clerk of the county in which the person has filed his or her fictitious business name statement.

Business and Professions Code Section 17930

Any person who executes, files, or publishes any statement under this chapter, knowing that such statement is false, in whole or

in part, shall be guilty of a misdemeanor and upon conviction thereof shall be punished by a fine not to exceed one thousand dollars ($1,000).

Fictitious Business Name Statement - 2010 Page 5

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