FICTITIOUS BUSINESS NAME ADDITIONAL INFORMATION (Business & Registrant names) FBN/ABANDONMENT FBN FILE NUMBER:_______________________________ PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK ADDITIONAL BUSINESS NAME(S) (1) __________________________________________________________________________________________ (2) __________________________________________________________________________________________ (3) __________________________________________________________________________________________ (4) __________________________________________________________________________________________ (5) __________________________________________________________________________________________ ADDITIONAL REGISTRANT NAME(S) Name of Registrant ­ First, Middle and Last for individual or name of Corp./LLC _________________________________________________________________ Residence Address (if Corp. or LLC enter the physical address of Corp./LLC) Name of Registrant ­ First, Middle and Last for individual or name of Corp./LLC _________________________________________________________________ Residence Address (if Corp. or LLC enter the physical address of Corp./LLC) ___________________________________________ City State Zip ___________________________________________ City State Zip ___________________________________________ If Corp., or LLC, then identify state of incorporation or organization (must be registered in CA). Name of Registrant ­ First, Middle and Last for individual or name of Corp./LLC _________________________________________________________________ Residence Address (if Corp. or LLC enter the physical address of Corp./LLC) ___________________________________________ If Corp., or LLC, then identify state of incorporation or organization (must be registered in CA). Name of Registrant ­ First, Middle and Last for individual or name of Corp./LLC _________________________________________________________________ Residence Address (if Corp. or LLC enter the physical address of Corp./LLC) ___________________________________________ City State Zip ___________________________________________ City State Zip ___________________________________________ If Corp., or LLC, then identify state of incorporation or organization (must be registered in CA). Name of Registrant ­ First, Middle and Last for individual or name of Corp./LLC _________________________________________________________________ Residence Address (if Corp. or LLC enter the physical address of Corp./LLC) ___________________________________________ If Corp., or LLC, then identify state of incorporation or organization (must be registered in CA). Name of Registrant ­ First, Middle and Last for individual or name of Corp./LLC _________________________________________________________________ Residence Address (if Corp. or LLC enter the physical address of Corp./LLC) ___________________________________________ City State Zip ___________________________________________ City State Zip ___________________________________________ If Corp., or LLC, then identify state of incorporation or organization (must be registered in CA). ___________________________________________ If Corp., or LLC, then identify state of incorporation or organization (must be registered in CA). I HEREBY CERTIFY THAT THIS IS A CORRECT COPY OF THE ORIGINAL STATEMENT ON FILE IN MY OFFICE. PETER ALDANA Assessor, County Clerk, Recorder By __________________________________, Deputy County of Riverside ACR 501 (Rev. 07/2014) Available in Alternate Formats American LegalNet, Inc. www.FormsWorkFlow.com