Fillable *SBCO Newspapers Instructions [ Tbl/ Lst] (San Bernardino County Assessor-Recorder-Clerk)

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*SBCO Newspapers Instructions [ Tbl/ Lst] (San Bernardino County Assessor-Recorder-Clerk)

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FICTITIOUS BUSINESS NAME: ADDITIONAL INFORMATION FORM
Additional Business Names (as shown in the Articles of Inc./Org./Reg.)
County of Principal
Place of Business
Enter Start Date or N/A
if not yet started
(2)
(3)
(4)
(5)
(6)
(7)
ADDITIONAL REGISTRANTS
*If a corp., LLC, etc., enter complete name, state of incorporation/organization/registration and registration number
(3) Name of Individual Registrant (First name)
(Middle initial only)
(Last name)
(3) Name of corporation or limited liability company as shown in the Articles of Inc/Org/Reg
State of Inc./Org./Reg.
(3) Residence Street Address (Mailing address is NOT acceptable)
City
State
Zip Code
(4) Name of Individual Registrant (First name)
(Middle initial only)
(Last name)
(4) Name of corporation or limited liability company as shown in the Articles of Inc/Org/Reg
State of Inc./Org./Reg.
(4) Residence Street Address (Mailing address is NOT acceptable)
City
State
Zip Code
(5) Name of Individual Registrant (First name)
(Middle initial only)
(Last name)
(5) Name of corporation or limited liability company as shown in the Articles of Inc/Org/Reg
State of Inc./Org./Reg.
(5) Residence Street Address (Mailing address is NOT acceptable)
City
State
Zip Code
(6) Name of Individual Registrant (First name)
(Middle initial only)
(Last name)
(6) Name of corporation or limited liability company as shown in the Articles of Inc/Org/Reg
State of Inc./Org./Reg.
(6) Residence Street Address (Mailing address is NOT acceptable)
City
State
Zip Code
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 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).
Printed Name
Title (if applicable)
Signature
Date
San Bernardino County
Recorder - Clerk
222 W. Hospitality Lane, 1
st
Floor, San Bernardino CA 92415-0022
(855) REC-CLRK
www.sbcounty.gov/arc
Rev. 2019
BUSINESS OWNER IS RESPONSIBLE TO DETERMINE IF PUBLICATION IS REQUIRED (BPC 17917). FILING IS A
PUBLIC RECORD (GC 6250-6277).
Please TYPE or PRINT legibly in DARK ink only and use additional sheets as needed.
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*SBCO Newspapers Instructions Tbl Lst (San Bernardino County Assessor-Recorder-Clerk)

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Completed 31 January 2021

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