SOLANO COUNTY CLERK 675 TEXAS STREET, SUITE 1900 FAIRFIELD, CA 94533 (707) 784-7510 CHARLES LOMELI STATEMENT OF WITHDRAWAL FROM PARTNERSHIP OPERATING UNDER FICTITIOUS BUSINESS NAME FILING FEE IS $ 40.00 (Cash, Cashier's Check or Money Order) FILE NUMBER SEE REVERSE SIDE FOR INSTRUCTIONS The following person(s) has/have withdrawn as a general partner(s) from the partnership operating under the fictitious business name of: Street Address City State Date Zip File # 2. County The Fictitious Business Name was filed in Solano County on 1. Full name-type/print Residence Address City State Zip County Full name-type/print Residence Address City State Zip County 3. Full name-type/print Residence Address City State Zip County 4. Full name-type/print Residence Address City State Zip County 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.) Signature of each withdrawing partner(s), print name next to signature. This statement was filed with the County Clerk of Solano County on the date indicated by the filed stamp above. I HEREBY CERTIFY THAT THIS COPY IS A CORRECT COPY OF THE ORIGINAL STATEMENT ON FILE IN MY OFFICE CHARLES LOMELI, SOLANO COUNTY CLERK BY: _____________________________________. Deputy Revised 2008 American LegalNet, Inc. www.FormsWorkFlow.com THE BELOW INSTRUCTIONS ARE NOT TO BE PUBLISHED (Sec. 17924 BUSINESS & PROFESSIONS CODE) INSTRUCTIONS FOR COMPLETION OF STATEMENT Section 17923 Business & Professions Code 17923 (a) "Any person who is a general partner in a partnership that is or has been regularly transacting business in a fictitious business name may, upon withdrawing as a general partner, file a statement of withdrawal from partnership operating under 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 of the county where the partnership filed its fictitious business name statement. 19723 (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 and the county where filed (3) The street address of its principal place of business in this state or, if it 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 of the person withdrawing as a partner 19723 (c) "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 in accordance with subdivision (a) and (b) and the requirement of subdivision (c) is satisfied." NOTICE TO PERSON(S) ­ Section 17924 Business and Professions Code 17924 (1) "The Statement of Withdrawal from Partnership operating under a fictitious business name must be published in a newspaper once a week for four successive weeks 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 is conducted (Business and Professions Code 17917." 17924 (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 ($1,000) (Business and Professions Code 17930)." Revised 2008 American LegalNet, Inc. www.FormsWorkFlow.com