Form Instructions on Next Page
1600 PACIFIC HIGHWAY, SUITE 260, SAN DIEGO, CA 92101
P.O. BOX 121750, SAN DIEGO, CA 92112-1750
(619) 237-0502
Ernest J. Dronenburg, Jr.
San Diego County
Recorder/County Clerk
www.sdarcc.com
STATEMENT OF ABANDONMENT OF USE OF FICTITIOUS BUSINESS NAME
(Business and Professions Code 17922)
FILING FEE $40.00
EACH ADDITIONAL COPY IS $2.00 AND EACH ADDITIONAL CERTIFIED COPY IS $3.00
(1) FICTITIOUS BUSINESS NAME(S) TO BE ABANDONED:
a.
______________________________________________________________________________
b.
______________________________________________________________________________
LOCATED AT: ____________________________________/___________/____/__________/________
Physical Business Address (No P.O. Boxes or Postal Facilities) City State County Zip Code
MAILING ADDRESS: ___________________________________________________________________
(2) THE FICTITIOUS BUSINESS NAME REFERRED TO ABOVE WAS FILED IN SAN DIEGO COUNTY ON:
_______/_______/_______, and assigned File no. _______-______________________________________
Date
(3) FICTITIOUS BUSINESS NAME IS BEING ABANDONED BY: (Individual, Corp., LLC, Gen. Partner etc.)
a. ______________________________________________________________________________________________________________________________________________________________
If individual-spell out first, middle, and last name or Corp/LLC
__________________________________________________________________________________________________________________________________________________________________
Residence Address, if Corp. or LLC enter physical address (No P.O. Boxes or Postal Facilities) City State Zip Code
_______________________________________________________________________________________
If Corporation or LLC Print State of Incorporation/Organization
b. ______________________________________________________________________________________________________________________________________________________________
If individual-spell out first, middle, and last name or Corp/LLC
__________________________________________________________________________________________________________________________________________________________________
Residence Address, if Corp. or LLC enter physical address (No P.O. Boxes or Postal Facilities) City State Zip Code
_______________________________________________________________________________________
If Corporation or LLC Print State of Incorporation/Organization
(4) THIS BUSINESS IS CONDUCTED BY: (Check one)
A. An Individual
E. Joint Venture
I. A Limited Liability Company
B. A Married Couple
F. A Corporation
J. Limited Liability Partnership
C. A General Partnership
G. A Trust
K. An Unincorporated Association-Other than a Partnership
D. A Limited Partnership
H. Co-Partners
L. State or Local Registered Domestic Partners
I declare that all information in this statement is true and correct. (A registrant who declares as true any material matter pursuant to Section 17913 of
the Business and Professions code that the registrant knows to be false is guilty of a misdemeanor punishable by a fine not to exceed one thousand
dollars ($1,000).)
Signature ___________________________________________________________________________________________________________________________________________________________
Printed Name ___________________________________________________________________________________________________________________________________________________
Title of Officer, if Limited Liability Company/Corporation______________________________________________________________________________________________________
This statement was filed with the San Diego Recorder/County Clerk as indicated by the file stamp above.
The form must be legible no erasures, whiteouts. Strikeovers are acceptable if accompanied with initials.
CC233 (Rev. 06/22/2017)
INSTRUCTIONS FOR COMPLETION OF THE ABANDONMENT STATEMENT
The form must be legible no erasures, whiteouts, strikeovers acceptable if accompanied with initials.
Business and Professions Code 17922
(a) Upon ceasing to transact business in this state under a fictitious business name that was filed in the previous five
years, a registrant who has filed a fictitious business name statement shall file a statement of abandonment of use of
fictitious business name. The statement of abandonment shall be executed in the same manner as a fictitious business
name statement, excluding the requirements of subdivisions (d), (e), and (f) of Section 17913 and shall be filed with the
county clerk of the county in which the registrant has filed the fictitious business name statement. The statement shall
be published in the same manner as a fictitious business name statement and an affidavit showing its publication shall be
filed with the county clerk after the completion of publication.
(b) The statement shall include:
(1) The name being abandoned and the street address of the principal place of business.
(2) The date on which the fictitious business name statement relating to the fictitious business name being abandoned
was filed, the file number, and the county where filed.
(3) In the case of an individual, the full name and residence address of the individual.
(4) In the case of a married couple, the full name and residence address of both parties to the marriage.
(5) In the case of a general partnership, a limited partnership, co-partners, a limited liability partnership, a joint
venture, or an unincorporated association other than a partnership, the full names and residence addresses of all of the
general partners.
(6) In the case of a corporation, the name and address of the corporation as set forth in its articles of incorporation on
file with the California Secretary of State.
(7) In the case of a trust, the full name and residence address of each of the trustees.
(8) In the case of a limited liability company, the name and address of the limited liability company as set forth in its
articles of organization on file with the California Secretary of State.
(9) In the case of state or local registered domestic partners, the full name and residence address of each domestic
partner.
INSTRUCTIONS ON NEWSPAPER PUBLICATION REQUIREMENTS
Publishing- Business & Professions Code Section 17917:
(a) Within 30 days after a fictitious business name statement has been filed pursuant to this chapter, the registrant shall
cause a statement in the form prescribed by subdivision (a) of Section 17913 to be published pursuant to Section 6064 of
the Government Code in a newspaper of general 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 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 newspaper of general
circulation in Sacramento County.
(b) Subject to the requirements of subdivision (a), the newspaper selected for the publication of the statement should be
one that circulates in the area where the business is to be conducted.
(c) 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 information required in the expired statement, provided the refiling is filed within 40 days of the
date the statement expired.
(d) An affidavit showing the publication of the statement shall be filed with the county clerk where the fictitious business
name statement was filed within 30 days after the completion of the publication.
CC233 (Rev. 06/22/2017)