Instructions For Completing The Application For Renewal - Department Of State printable pdf download

PLEASE READ ALL INSTRUCTIONS CAREFULLY BEFORE COMPLETING THE FORM. IF YOU

NEED ASSISTANCE, PLEASE CALL (850) 488-9000.

INSTRUCTIONS FOR COMPLETING THE APPLICATION FOR RENEWAL

Block 1. Block is preprinted with the fictitious name, the registration number, and mailing address of the business as it was originally

registered with this office. The name of the business cannot be changed on the statement of renewal. A

cancellation/reregistration must be filed. Please call (850) 487-6058 for the appropriate form.

Block 2. If the mailing address printed in block 1 is incorrect, enter the correct mailing address in block 2. 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

RENEWAL FORM WILL BE SENT TO THE ADDRESS IN BLOCK 1 OR AS CHANGED IN BLOCK 2. WE WILL

NOT SEND CERTIFICATION TO ANY OTHER ADDRESS OR REDIRECT MAIL RETURNED TO THIS OFFICE.

Block 3. Block is preprinted with the Federal Employer’s Identification (FEI) number. If blank, enter the FEI number or check the

appropriate box. For FEI number assistance, call the IRS at 1-800-829-1040.

Block 4. Block is preprinted with the date filed in this office; if blank enter the correct file date, if known.

Block 5. Block is preprinted with the county of the principal place of business. “MULTIPLE” may be printed if more than one

county

was reported when original registration was filed; change if necessary.

Block 6. Should you desire a certificate of status, please check the box in block 6 and include an additional $10.00 with the filing fee.

The certificate of status will be sent to the address in block 1 or in block 2, if changed.

Block 7. Block 7 contains the Fictitious Name owner(s), their addresses, document number and Federal Employer Identification

Number (FEI) if applicable. (Due to Space limitations only four owners are printed.) If there are additional owners, please

list them on an attached sheet or in block 8 as additions. Do not make any changes in block 7 unless deleting an owner.

Owners listed that are not individuals must be registered and active with this office or provide documentation as to why they

are not required to register. Examples would be Federally Chartered Corporations or Legislatively created entities. NOTE:

If the fictitious name indicated in block 1 contains the word(s) “corporations” or “incorporated”, or the abbreviation

“corp.”or “Inc.”, the owner(s) must be a corporation registered or incorporated with this state.

Block 8. Block 8 is for changes or additions to the owners in block 7. Changes must be typed or printed in ink and legible. Owners

that are not individuals must be registered and active with this office or provide documentation as to why they are not

required to register. Examples would be Federally Chartered Corporations or Legislatively created entities. NOTE: If the

fictitious name indicated in block 1 contains the word(s) “corporations” or “incorporated”, or the abbreviation “corp.” or

Inc.”, the owner(s) must be a corporation registered or incorporated with this state.

Block 9. This renewal must be signed in block 9 with an original signature by at least one owner that is listed in block 7, block 8 if a

change, or on an attachment.

If this Application for Renewal of Fictitious Name is not filed on or before December 31, of the fifth

year the fictitious name will be canceled and removed from the records of the Department of State.

This renewal application must be post-marked by December 31, of the year in which it expires.

After the Application for Renewal is filed, the effectiveness of the fictitious name registration is

continued for an additional five years.

Mailing Address:

Other Correspondence:

Street Address:

Fictitious Name Renewal

Division of Corporations

P.O. Box 6327

409 E. Gaines St.

P.O. Box 1300

Tallahassee, FL 32314

Tallahassee, FL 32399

Tallahassee, FL 32302-1300

Instructions For Completing The Application For Renewal - Department Of State

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