File or Mail fonus and $17.00 fee (Space Below for Use by County Clerk Only) Brandi L. Orth ctor E. Salazar Fresno Connty Clerk 2221 Kern Street Fresno, CA 93721 Phone: (559) 600-2575 488-3428 STATEMENT OF WITBDRAWAL FROM PARTNERSHIP OPERATlNG UNDER FICTITIOUS BUSlNESS NAME The following person(s) has(have) withdrawn as a general partner(s) from operating under the fictitious business name(s) of: Name of business: At business address: I. 2. DATE The fictitious business name statement for the partnership was filed in the office of Victor E. Salazar, Fresno County Clerk on -.""",--_ _ The full name of the person withdrawing as a partner is: 3. Residence Address: STREET ADDRESS CITY STATE Zip The full name of the person withdrawing as a partner is: 4. Residence Address: STREET ADDRESS CITY STATE Zip Signed: Signed: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ____ "1 declare that all in/o17nation in this statement is true and correct. (A registrant who declares as tl1le information which he or she to be false is guilty ofcrime). k710WS 5. D This statement was filed pursuant to Section 17919 ofthe Business and Profession Code. This Withdrawal was filed with the Fresno County Clerk on NOTICE PURSUANT TO SECTION 17924 OF THE BUSlNESS AND PROFESSIONS CODE This statement of withdrawal of use of fictitious business name must be published in a newspaper once a week for four successive weeks. The first publication date must be within thirty (30) days from date of filing and an affidavit of publication filed with the County Clerk within 30 days after 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 was conducted. (Section 17917 Business and Professions Code) Any person who executes, files or published any statement under Chapter 5 (commencing with Section 17900), part 3 of Division 7 of the Business and Professions Code, knowing that such statement is false, in whole or in part, shall be guilty of a misdemeanor and upon conviction thereof, shall be punished by a fine not to exceed five hundred dollars ($500). (Section 17930 Business and Professions Code) CG-l10(Q4.UJ) American LegalNet, Inc. www.FormsWorkFlow.com