Fictitious Business Name (FBN) Filing Requirements

1. Name(s) of fictitious business(es) B&P 17913(b)
2. Street address and county of principal place of business B&P 17913(b)(2)
3. Full name of registrant(s) B&P17913(b)(3)
4. Residence address of registrant(s) B&P 17913(b)(3)

Note: If registrant is registered with the Secretary of State as a corporation or a limited liability company insert the address as shown on the California Secretary of State website of the current corporate/company address.

5.  The nature in which the business is being conducted B&P 17913(b)(4)
6. The date of the start of the business, or N/A B&P 17913(b)(5)
7. Declaration by registrant that all of the information in the FBN statement is true and correct B&P 17913(c)
8. Signature of registrant B&P 17914 *see Registrants Required/Who Can Sign
9. Government issued identification for all in-person filers (including agents) B&P 17913(d)