Instructions for Completing Application for Registration of Fictitious Name
Section 1:
Line 1: Enter the name as you wish it to be registered. A fictitious name may not contain the words
“Corporation” or “Incorporated,” or the abbreviations “Corp.” or “Inc.,” unless the person or business for which
the name is registered is incorporated or has obtained a certificate of authority to transact business in this state
pursuant to chapter 607 or chapter 617 Florida Statutes.
Line 2: Enter the mailing address of the business. This address does not have to be the principal place of
business and can be directed to anyone’s attention. DO NOT USE AN ADDRESS THAT IS NOT YET
OCCUPIED. ALL FUTURE MAILINGS AND ANY CERTIFICATION REQUESTED ON THIS REGISTRATION
FORM WILL BE SENT TO THE ADDRESS IN SECTION 1. An address may be changed at any future date
with no charge by simply writing the Division.
Line 3: Enter the name of the county in Florida where the principal place of business of the fictitious name is
located. If there is more than one county, list all applicable counties or state “multiple”.
Line 4: Enter the Federal Employer Identification (FEI) number if known or if applicable.
Section 2:
Part A: Complete if the owner(s) of the fictitious name are individuals. The individual’s name and address must
be provided. The social security number is not mandatory. Information provided on this application is a public
record and, as such, will be made accessible to the public.
Part B: Complete if the owner(s) are not individuals. Examples are a corporation, limited partnership, joint
venture, general partnership, trusts, fictitious name, etc. Provide the name of the owner, their address, their
registration number as registered with the Division of Corporations, and the Federal Employer Identification
(FEI) number. An FEI number must be provided or the appropriate box must be checked.
Owners listed in Part B must be registered with the Division of Corporations or provide documentation as to why
they are not required to register. Examples would be Federally Chartered Corporations, or Legislatively created
entities.
Additional owners may be listed on an attached page as long as all of the information requested in Part A or
Part B is provided.
Section 3:
Only one signature is required. It is preferred that a daytime phone number be provided in order to contact the
applicant if there are any questions about the application.
TO CANCEL A REGISTRATION ON FILE
Section 4:
Provide fictitious name, date filed, and registration number of
:
the fictitious name to be cancelled.
TO CHANGE OWNERSHIP OF A REGISTRATION:
Complete section 4 to cancel the original
registration. Complete sections 1 through 3 to re-register the fictitious name listing the new owner(s). An
owner’s signature is required in both sections 3 and 4.
TO CHANGE THE NAME OF A REGISTRATION:
Complete section 4 to cancel the original registration.
Complete sections 1 through 3 to re-register the new fictitious name. An owner’s signature is required in both
sections 3 and 4.
An acknowledgement letter will be mailed once the fictitious name registration has been filed.
If you wish to receive a certificate of status and/or certified copy at the time of filing of this registration, check the appropriate box at
the bottom of the form. PLEASE NOTE: Acknowledgements/certificates will be sent to the address in Section 1. If a certificate of
status is requested, an additional $10 is due. If a certified copy is requested, an additional $30 is due.
The registration and re-registration will be in effect until December 31 of the fifth year.
Send completed application with appropriate fees to:
Fictitious Name Registration
Internet Address:
PO Box 1300
Tallahassee, FL 32302-1300
The fee for registering a fictitious name is $50. Please make a separate check for each filing payable to the Department of State.
Application must be typed or printed in ink and legible.