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Fictitious Business Name Statement (Los Angeles) - California
| Fictitious Business Name Statement (Los Angeles) Form. This is a California form and can be used in Registrar-Recorder-County Clerk Los Angeles Local County . |
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R A R- CO RE RD ER /C OU NT Y Los Angeles County REGISTRAR-RECORDER/COUNTY CLERK ER CL RE GI ST Y OF AL LO -C S A NG ELE S DEAN C. LOGAN Registrar-Recorder/County Clerk IF O RNI A K NT COU Customer Contact Information Name: __________ (First) __________ (Last) Telephone #: _________________ (Optional) Email: ______________________ (Optional) * This form will be used by the Registrar-Recorder/County Clerk's Business Filing and Registration Section to contact you regarding any error(s) or omission(s) that may result in a delay of processing your Fictitious Business Name Statement. American LegalNet, Inc. www.FormsWorkFlow.com YOUR RETURN MAILING ADDRESS NAME: ADDRESS: CITY: STATE: ZIP CODE: LOS ANGELES REGISTRAR-RECORDER/ COUNTY CLERK FICTITIOUS BUSINESS NAME STATEMENT TYPE OF FILING AND FILING FEE (Check one) Original- $26.00 (FOR ORIGINAL FILING WITH ONE BUSINESS NAME ON STATEMENT) New (Amended) Filing- $26.00 (CHANGES IN FACTS FROM ORIGINAL FILING- REQUIRES PUBLICATION) Refile- $26.00 (NO CHANGES IN THE FACTS FROM ORIGINAL FILING) $5.00- FOR EACH ADDITIONAL BUSINESS NAME FILED ON SAME STATEMENT, DOING BUSINESS AT THE SAME LOCATION $5.00- FOR EACH ADDITIONAL OWNER IN EXCESS OF ONE OWNER The following person(s) is (are) doing business as: *1._____________________________________ 2.____________________________________ Print Fictitious Business Name(s) **_________________________________________|_________________________________ Street address of principal place of business City State Zip City Mailing address if different State Zip __________________________________________ |_________________________________ COUNTY Articles of Incorporation or Organization Number (if applicable): AI #ON_________________________________________________ *** REGISTERED OWNER(S): 1. __________________________________ Full Name/Corp/LLC (P.O. Box not accepted) 2. _________________________________ Full Name/Corp/LLC (P.O. Box not accepted) __________________________________ Residence Address _________________________________ Residence Address __________________________________ City State Zip _________________________________ City State Zip __________________________________ If Corporation or LLC Print State of Incorporation/Organization _________________________________ If Corporation or LLC Print State of Incorporation/Organization 3. __________________________________ Full Name/Corp/LLC (P.O. Box not accepted) 4. _________________________________ Full Name/Corp/LLC (P.O. Box not accepted) __________________________________ Residence Address _________________________________ Residence Address __________________________________ City State Zip _________________________________ City State Zip __________________________________ If Corporation or LLC Print State of Incorporation/Organization _________________________________ If Corporation or LLC Print State of Incorporation/Organization IF MORE THAN FOUR REGISTRANTS, ATTACH ADDITIONAL SHEET SHOWING OWNER INFORMATION **** THIS BUSINESS IS CONDUCTED BY: (Check one) an Individual a General Partnership a Limited Partnership a Limited Liability Company an Unincorporated Association other than a Partnership a Corporation a Trust Copartners a Married Couple Joint Venture State or Local Registered Domestic Partners a Limited Liability Partnership ***** The date registrant commenced to transact business under the fictitious business name or names listed above on ____________________________ (Insert N/A above if you haven't started to transact business) I declare that all information in this statement is true and correct. (A registrant who declares as true information which he or she knows to be false is guilty of a crime.) REGISTRANT/CORP/LLC NAME (PRINT) ____________________________________________TITLE______________________________________ REGISTRANT SIGNATURE ____________________IF CORP OR LLC, PRINT NAME________________________ If corporation, also print corporate title of officer. If LLC, also print title of officer or manager. This statement was filed with the County Clerk of LOS ANGELES on the date indicated by the filed stamp in the upper right corner. NOTICE IN ACCORDANCE WITH SUBDIVISION (a) OF SECTION 17920, A FICTITIOUS NAME STATEMENT GENERALLY EXPIRES AT THE END OF FIVE YEARS FROM THE DATE ON WHICH IT WAS FILED IN THE OFFICE OF THE COUNTY CLERK, EXCEPT, AS PROVIDED IN SUBDIVISION (b) OF SECTION 17920, WHERE IT EXPIRES 40 DAYS AFTER ANY CHANGE IN THE FACTS SET FORTH IN THE STATEMENT PURSUANT TO SECTION 17913 OTHER THAN A CHANGE IN THE RESIDENCE ADDRESS OF A REGISTERED OWNER. A NEW FICTITIOUS BUSINESS NAME STATEMENT MUST BE FILED BEFORE THE EXPIRATION. THE FILING OF THIS STATEMENT DOES NOT OF ITSELF AUTHORIZE THE USE IN THIS STATE OF A FICTITIOUS BUSINESS NAME IN VIOLATION OF THE RIGHTS OF ANOTHER UNDER FEDERAL, STATE, OR COMMON LAW (SEE SECTION 14411 ET SEQ., BUSINESS AND PROFESSIONS CODE). I HEREBY CERTIFY THAT THIS COPY IS A CORRECT COPY OF THE ORIGINAL STATEMENT ON FILE IN MY OFFICE. DEAN C. LOGAN, LOS ANGELES COUNTY CLERK Rev. 01/2013 P.O. BOX 1208, NORWALK, CA 90651-1208 BY: _____________________________________________, Deputy PH: (562) 462-2177 WEB ADDRESS: LAVOTE.NET American LegalNet, Inc. www.FormsWorkFlow.com 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 a married couple, insert the full name and residence address of both parties to the marriage (c) If the registrant is a general partnership, copartnership, joint venture, limited liability partnership, or unincorporated association other than a partnership,
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