Instructions for Completing Application for Registration of Fictitious Name
Section 1: Line 1: Enter the name as you wish it to be registered. A fictitious name may not contain words, abbreviations or designations that
comprise a business entity suffix or indicator (e.g., “Corporation,” “Incorporated,” “Professional Association,” “Limited Liability
Company,” “Professional Limited Liability Company,” “Limited Liability Partnership,” “Limited Partnership,” “Corp.,” “Inc.,” “P.A.,”
“L.L.C.,” “P.L.L.C.,” “L.L.P.,” “L.P.,” etc.) unless the person or business for which the name is registered is a business entity of the
same type duly incorporated, organized, formed or registered in Florida or otherwise authorized to transact business in Florida.
Business entities are not required to file under their exact entity name.
ection 655.922, Florida Statutes, prohibits anyone other than financial institutions to use the word(s) "bank," "banc," "banco,"
'banque," "banker," "trust company," "savings and loan association," "savings bank," or "credit union," or words of similar import.
Line 2: Enter the mailing address of the business. This address does not have to be the principal place of business and can be
directed to anyone’s attention. DO NOT USE AN ADDRESS THAT IS NOT YET OCCUPIED. ALL FUTURE MAILINGS AND ANY
CERTIFICATION REQUESTED ON THIS REGISTRATION FORM WILL BE SENT TO THE ADDRESS IN SECTION 1. An address
may be changed at any future date with no charge by simply writing the Division.
Line 3: Enter the name of the county in Florida where the principal place of business of the fictitious name is located. If there is
more than one county, list all applicable counties or state “multiple”.
ne 4: Enter the Federal Employer Identification (FEI) number if known or if applicable. Please do not enter your social security
ection 2: Part A: Complete if the registrant(s) of the fictitious name are individuals. The individual’s name and address must be provided.
art B: Complete if the registrant (s) are not individuals. Examples are a corporation, limited liability company, limited partnership,
joint venture, general partnership, trusts, etc. Provide the name of the registrant(s), their address(es), their document number(s) as
registered with the Division of Corporations, and the Federal Employer Identification (FEI) number. An FEI number must be provided
for each registrant or the appropriate box must be checked.
egistrants listed in Part B must be registered with the Division of Corporations or provide documentation as to why they are not
required to register. Examples would be Federally Chartered Corporations, or Legislatively created entities.
ith respect to a general partnership that is not registered with the Division of Corporations, its partners are the registrants and not
the partnership entity. With respect to a general partnership that is registered with the Division of Corporations, the partnership is
In order for the fictitious name registration to be filed, each entity that is a registrant must be in active status with the Division of
Corporations at the time the fictitious name registration is filed.
Additional registrants may be listed on an attached page as long as all of the information requested in Part A or Part B is provided.
ection 3: Signature of the registrant is required. It is preferred that a daytime phone number be provided in order to contact the registrant if
there are any questions about the application.
Section 4: TO CANCEL A REGISTRATION ON FILE: Provide fictitious name, date filed, and registration number of the fictitious name to be
cancelled. A registrant’s signature is required for cancellation.
O CHANGE A REGISTRATION: Complete section 4 to cancel the original registration. Complete sections 1 through 3 to re-
register the fictitious name listing the new registrant(s). A registrant’s signature is required in both sections 3 and 4.
O CHANGE THE NAME OF A REGISTRATION: Complete section 4 to cancel the original registration. Complete sections 1
through 3 to re-register the new fictitious name. A registrant’s signature is required in both sections 3 and 4.
An acknowledgement letter will be mailed when the fictitious name registration has been filed. The acknowledgement letter and any certification
requested will be mailed to the address provided in Section 1. For Cancellations Only: please provide a mailing address on an attachment, if the
address on our records is no longer valid. To request a certificate of status and/or certified copy, please check the appropriate box(es) and include the
additional fee(s) ($10 for a certificate of status, $30 for a certified copy).
A registration or a reregistration will be in effect until December 31 of the fifth calendar year, thereafter.
end completed application with appropriate fees to:
he fee for registering a fictitious name is $50. Please make a separate check for each filing payable to the Department of State. Application must be
typed or printed in ink and legible.
Single CR4E001 (11/17)
Fictitious Name Registration
PO Box 6327
Tallahassee, FL 32314
Division of Corporations
2661 Executive Center Circle