MARY B. BEDARD, CPA
Kern County Auditor-Controller-County Clerk
1115 Truxtun Avenue, Bakersfield, CA 93301
(661) 868-3588
FICTITIOUS BUSINESS NAME ADDENDUM
1
Additional Fictitious Business Names
DBA # 4:
DBA # 5:
DBA # 6:
DBA # 7:
DBA # 8:
DBA # 9:
DBA # 10:
DBA #11:
DBA #12:
2
Registrant(s
): Individual or partners: list your full legal name separately, as indicated. Spouses; list separately.
Corps, LLC, or LP: list name and state of corporation or organization. (Attach add’l FBN Addendum pages as needed).
D
Full name of individual, partner, or name of Corporation, LLC, or LP:
State of incorporation or
organization:
Residence street address (P.O. Box not acceptable):
City State Zip
E
Full name of individual, partner, or name of Corporation, LLC, or LP:
State of incorporation or
organization:
City
State
Zip
F
Full name of individual, partner, or name of Corporation, LLC, or LP:
State of incorporation or
organization:
City
State
Zip
G
Full name of individual, partner, or name of Corporation, LLC, or LP:
State of incorporation or
organization:
Residence street address (P.O. Box not acceptable):
City
State Zip
Signature is required on Page 1
and
any additional pages
BY SIGNING BELOW, I DECLARE THAT ALL INFORMATION IN THIS STATEMENT IS TRUE AND CORRECT.
A registrant who declares as true information, which he or she knows to be false, is guilty of a crime (B&P Code 17913).
I am also aware that all information on this statement becomes Public Record upon filing.
Printed Name Signature Date
Distribution:
DBA #1: