FICTITIOUS BUSINESS NAME STATEMENT- $30.00

(1) FICTITIOUS BUSINESS NAME(S)
(2) LOCATED AT:	Address: City: State: AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY County: Postal Code:
(Must have Street Address of Business including City, State, and Zip---- P.O. Box not acceptable)
Mailing Address:
(Optional)
(3) THIS BUSINESS IS CONDUCTED BY:
An Individual	Joint Venture	A Limited Liability Company
Husband and Wife	A Corporation	Limited Liability Partnership
A General Partnership	A Trust	Unincorporated Association-Other than a        Partnership
A Limited Partnership	Co-Partners	Domestic Partners
(4) THE FIRST DAY OF BUSINESS WAS (mm/dd/yyyy):        OR - IF NOT YET STARTED, CHECK HERE:
(5) THIS BUSINESS IS HEREBY REGISTERED BY THE FOLLOWING:
Owner’s Name or Corporation Name if incorporated Residence/Corporation/LLC Street Address(P.O. Box not acceptable) City State (2 digits) Zip Corporation or LLC - Enter State of Incorporation/Organization

NOTICE – THIS FICTITIOUS NAME STATEMENT EXPIRES FIVE (5) YEARS FROM THE DATE IT WAS FILED IN THE OFFICE OF THE COUNTY CLERK. A NEW FICTITIOUS BUSINESS NAME STATEMENT MUST BE FILED BEFORE THAT TIME.

THE FILING OF THIS STATEMENT DOES NOT OF ITSELF AUTHORIZE THE USE IN THIS STATE OF A FICTITIOUS BUSINESS NAME IN VIOLATIION OF THE RIGHTS OF ANOTHER UNDER FEDERAL, STATE, OR COMMON LAW (SEE SECTION 14411 ET SEQ., BUSINESS AND PROFESSIONS CODE.)

IT IS THE RESPONSIBILITY OF THE REGISTRANT TO DETERMINE THAT THE FICTITIOUS BUSINESS NAME SELECTED WILL NOT VIOLATE ANOTHER’S RIGHTS ESTABLISHED UNDER LAW.

Would you like a copy to send to a newspaper to meet the publications requirements?	$ 2.00	Yes No
Would you like a copy for your records?	$ 2.00	Yes No

ARCC.FGG@sdcounty.ca.gov