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INSTRUCTIONS FOR COMPLETION OF STATEMENT <br /> Business and Professions Code Section 17913: <br /> *Where one asterisk appears in the form: <br /> (a) Insert the fictitious business name or names <br /> (b)Only those businesses operated at the same address and under the same ownership may be listed on one statement <br /> *`Where two asterisk appears in the form: <br /> (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 <br /> (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 <br /> this state and file with the Clerk of Sacramento County(B&P 17915) <br /> (c)Mail Box and Post Office Box Numbers are not acceptable as a business address when used alone without a street address <br /> ***Where three asterisk appears in the form: <br /> (a) If the registrant is an individual,insert his or her full name and residence address <br /> (b) If the registrants are a married couple,insert the full name and residence address of both the parties to the marriage <br /> (c) If the registrant is a general partnership,co-partnership,joint venture,limited liability partnership,or unincorporated association other <br /> than a partnership,insert the full name and residence address of each general partner <br /> (d) If the registrant is a limited partnership,insert the full name and residence address of each general partner <br /> (e) If the registrant is a limited liability company,insert the name and address of the limited liability company,as set out in its articles of <br /> organization on file with the CA Secretary of State,and the state of organization <br /> (f) If the registrant is a trust,insert the full name and residence address of each trustee <br /> (g) If the registrant is a corporation,insert the name and address of the corporation,as set out in its articles of incorporation on file with the CA <br /> Secretary of State,and the state of incorporation <br /> (h) If the registrants are state or local registered domestic partners,insert the full name and residence address of each domestic partner <br /> ****Where four asterisk appears in the form: <br /> a)Check whichever of the terms listed on the front of the form that best describes the nature of the business.Corporations and limited liability <br /> companies must include state filed Articles of Incorporation. State Articles also required when re-filing Fictitious Business Name Statement. <br /> *****Where five asterisk appears in the form: <br /> (a) Insert the date on which the registrant first commenced to transact business under the fictitious business name or names listed,if already <br /> transacting business under that name or names <br /> (b) Insert N/A if you have not yet commenced to transact business under the fictitious business name or names listed <br /> Business and Professions Code Section 17914 <br /> The statement shall be signed as follows: <br /> (a) If the registrant is an individual,by the individual <br /> (b) If the registrants are a married couple,by either party to the marriage. <br /> (c) If the registrant is a general partnership,limited partnership,limited liability partnership,co-partnership,joint venture,or unincorporated <br /> association other than a partnership,by a general partner <br /> (d) If the registrant is a limited liability company,by a manager or officer <br /> (e) If the registrant is a trust,by a trustee <br /> (f) If the registrant is a corporation,by an officer <br /> (g) If the registrant is a state or local registered domestic partnership,by one of the domestic partners <br /> Business and Professions Code Section 17915 <br /> The fictitious business name statement shall be filed with the clerk of the county in which the registrant has his or her principal place of business in this <br /> 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 <br /> 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 <br /> subdivision are also met. If your principal place of business is not in San Joaquin County,a proof of filing in the principal place of business is required.If your <br /> principal place of business is not in this state,a proof of filing with the Clerk of Sacramento County is required. <br /> Business and Professions Code Section 17917 <br /> Publication for Original, New Filings(renewal with change in facts from previous filing),or Refile <br /> (a)Within 30 days after a fictitious business name statement has been filed,the registrant shall cause it to be published in a newspaper of general <br /> circulation in the county where the fictitious business name statement was filed or,if there is no such newspaper in that county,in a newspaper <br /> of general circulation in an adjoining county. If the registrant does not have a place of business in this state,the notice shall be published in a <br /> newspaper of general circulation in Sacramento County.The publication must be once a week for four successive weeks and an affidavit of <br /> publication must be filed with the county clerk where the fictitious business name statement was filed within 30 days after the completion of the <br /> publication. <br /> (b) If a refiling is required because the prior statement has expired,the refiling need not be published,unless there has been a change in the <br /> information required in the expired statement,provided the refiling is filed within 40 days of the date the statement expired. <br /> Business and Professions Code Section 17922 <br /> Abandonment of Fictitious Business Name <br /> (a) Upon ceasing to transact business in this state under a fictitious business name that was filed in the previous five years,a person who has filed <br /> a fictitious business name statement shall file a statement of abandonment of use of fictitious business name.The statement shall be executed <br /> and published in the same manner as a fictitious business name statement and shall be filed with the county clerk of the county in which the <br /> person has filed his or her fictitious business name statement. <br /> Business and Professions Code Section 17930 <br /> Any person who executes,files,or publishes any statement under this chapter,knowing that such statement is false,in whole or <br /> in part,shall be guilty of a misdemeanor and upon conviction thereof shall be punished by a fine not to exceed one thousand dollars($1,000). <br /> San Joaquin County Assessor/Recorder/County Clerk 277(08/2015) Original-Recorder Yellow-Newspaper Pink-Customer <br />