Instructions for Completion of Document
1. Insert the Fictitious Business Name(s) that the partner(s) is/are withdrawing from.
2. Insert the complete physical address of the principal place of Business.
3. Insert the full name and residence address of all partners withdrawing from the partnership under the stated
Fictitious Business Name(s). All withdrawing partners must sign this form.
Business & Professions Code – Section 17923
(A) Any person who is a general partner in a partnership that is or has been regularly transacting business
under a fictitious business name may, upon withdrawing as a general partner, file a statement of
withdrawal from the partnership operating under a fictitious business name. The statement shall be
executed by the person filing the statement in the same manner as a fictitious business name statement
and shall be filed with the county clerk or the county where the partnership filed its fictitious business
(B) The statement shall include: 1. The fictitious business name of the partnership. 2. The date on which
the fictitious business name statement for the partnership was filed, the file number, and the county
where it was filed. 3. The street address of its principal place of business in this state, or if has no place
of business in this state, the street address of its principal place of business outside this state, if any. 4.
The full name and residence address of the person withdrawing as partner.
(C) The statement of withdrawal from the partnership operating under a fictitious business name shall be
published in the same manner as the fictitious business name statement and an affidavit showing the
publication of the statement shall be filed with the county clerk after the completion of publication.
(D) The withdrawal of a general partner does not cause a fictitious business name statement to expire if the
Withdrawing partner files a statement of withdrawal meeting the requirements of this section.
Notice to Person(s) – Business & Professions Code - Section 17924
(A) The county clerk shall furnish without charge a form satisfying the requirements of subdivision (a) of
Section 17913. The form prepared by the county clerk, or the material provided by him with the form,
shall include statements substantially as follows:
1. “Your fictitious business name statement must be published in a newspaper once a week for four
successive weeks and an affidavit of publication filed with the county clerk when publication has
been accomplished. The statement should be published in a newspaper of general circulation in
the county where the principal place of business is located. The statement should be published in
such county in a newspaper that circulates in the area where the business is to be conducted
(Business and Professions Code Section 17917)”
2. “Any person who executes, files, or publishes any fictitious business name statement, knowing
that such statement is false, in whole or in part, is guilty of a misdemeanor and upon conviction
thereof shall be fined not to exceed one thousand dollars ($1000) (Business and Professions
Code Section 17930).”
(B) The county clerk may furnish without charge forms meeting the requirements for a statement of
abandonment of use of a fictitious business name and a statement of withdrawal from
partnership operating under a fictitious business name.