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Fictitious Business Name Statement (San Francisco) - California
|Fictitious Business Name Statement (San Francisco) Form. This is a California form and can be used in County Clerk San Francisco Local County .||
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THIS STATEMENT IS A TTX Cert#: ___________________ Current: _____________________ ABOVE FOR OFFICE USE ONLY PUBLIC RECORD FILING STAMP ONLY (SEE REVERSE SIDE FOR LEGAL REQUIREMENTS AND INSTRUCTIONS) San Francisco County Clerk City Hall, Room 168 San Francisco, CA 94102-4678 www.sfgov.org/countyclerk st FILING FEE: (See website for methods of payment) $46.00 For 1 Business Name and 1 Registrant $11.00 For each additional business name or each additional registrant (owner) on SAME statement ITEMS #1 THROUGH #6 MUST BE LEGIBLE AND FULLY COMPLETED; SUBMIT FORM IN DUPLICATE st Any alterations, deletions, or other format to this twopage form will not be accepted for filing by the Office of the SF County Clerk. FICTITIOUS BUSINESS NAME STATEMENT 1. Fictitious Business Name(s): ____________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________ 2. Street Address, City, State and Zip code of Principal Place of Business (P.O. Box NOT allowed) MUST ENTER COUNTY OF FBN ADDRESS: 3. Full name of registrant #1 (If Corporation or Limited Liability Company, also indicate State of incorporation or organization, e.g. (CA), (DE), etc) Residence Address (P.O. Box NOT allowed) City, State and Zip Code Full name of registrant #2 (If Corporation or Limited Liability Company, also indicate State of incorporation or organization, e.g. (CA), (DE), etc) Residence Address (P.O. Box NOT allowed) City, State and Zip Code Full name of registrant #3 (If Corporation or Limited Liability Company, also indicate State of incorporation or organization, e.g. (CA), (DE), etc) Residence Address (P.O. Box NOT allowed) City, State and Zip Code Full name of registrant #4 (If Corporation or Limited Liability Company, also indicate State of incorporation or organization, e.g. (CA), (DE), etc) Residence Address (P.O. Box NOT allowed) City, State and Zip Code 4. The business is conducted by: an individual a general partnership a corporation a limited partnership an unincorporated association other than a partnership a trust co-partners a married couple joint venture limited liability company state or local registered domestic partners a limited liability partnership 5. The registrant commenced to transact business under the above-listed fictitious business name or names on: (enter EXACT date OR if future date, enter "not applicable") 6. I declare that all information in this statement is true and correct. (A registrant who declares as true information of which he or she knows to be false is guilty of a crime.) If registrant other than Corp. or LLC, sign below If registrant is a Corporation or Limited Liability Company, sign below Signed _________________________________ Printed Name____________________________ Corporation or LLC Name: ______________________________________ Signature ___________________________________________________ Printed Name & Title __________________________________________ This statement was filed with the San Francisco County Clerk on date indicated by the file stamp above. 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). CERTIFICATION I hereby certify that the foregoing is a correct copy of the original on file at the Office of San Francisco County Clerk. By _______________________________, Deputy County Clerk FBNS.doc American LegalNet, Inc. www.FormsWorkFlow.com Rev. 01/01/2013 NOTICE TO REGISTRANT PURSUANT TO CA BUSINESS & PROFESSIONS CODE 17900 et seq. & SF BUS. & TAX REG. Article 12 1. Search our index (available at our office or online at www.sfgov.org/countyclerk) for the fictitious business name(s) (FBN) you plan to file. It is your responsibility to check other sources to ensure you are not infringing on other businesses' trademark or common law rights. Other suggested sites are the Secretary of State's Corporate Division at http://www.ss.ca.gov/business/corp/corporate.htm, the U.S. Patents and Trademark Office at http://www.uspto.gov/ or the S.F. Public Library. You must register your business with the S.F. Tax Collector located at City Hall, Room 140. Phone: (415) 554-4400. Website: 2. 3. www.sfgov.org/tax prior to submitting FBN statement. Bring or mail completed FBN statement along with the filing fee (stated at top of form) and proof of registration with the S.F. Tax Collector's Office. Note: New accounts require receipt issued by the S.F. Tax Collector's Office. Accounts not showing current status on Tax Collector's records require Temporary Verification of Registration (TVR) form issued by the S.F. Tax Collector's Office. If processing the FBN statement by mail, include a self-addressed stamped envelope. *The fictitious business name statement shall be filed with the county 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. (B&P Code Sec. 17915)* FIRST FILINGS: Your fictitious business name statement must be published in a newspaper within 30 days after the statement has been filed with the County Clerk. The statement must be published once a week for four consecutive weeks and an original affidavit proof of publication must be filed with the County Clerk within 30 days after publication has been completed. The statement should be published in a newspaper of general circulation in the county where the principal place of business is located. (B&P Code Sec.