FILE #_______________________________ OFFICE OF THE SUTTER COUNTY CLERK 433 Second Street, Yuba City CA 95991 (530) 822-7134 FICTITIOUS BUSINESS NAME STATEMENT OF WITHDRAWL FROM PARTNERSHIP FILING FEE $20.25 This space reserved for County Clerk The following person (persons) has/have withdrawn as a general partner(s) from the partnership operating under the Fictitious Business Name of: ___________________________________________________________________________ Print Fictitious Business Name(s) ___________________________________________________________________________ Street address of principal place of business __________________________________________ _________________________________ City State Zip COUNTY The Fictitious Business Name Statement was filed in Sutter County on ___________ as File No.______________________ THE FULL NAME(S) AND RESIDENCE ADDRESS(ES) OF THE WITHDRAWING PARTNER(S) ARE AS FOLLOWS: 1. __________________________________ Full Name 2. _________________________________ Full Name __________________________________ Residence Address _________________________________ Residence Address __________________________________ City State Zip _________________________________ City State Zip 3. __________________________________ Full Name 4. _________________________________ Full Name __________________________________ Residence Address _________________________________ Residence Address __________________________________ City State Zip _________________________________ City State Zip (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.) I declare that all information in this statement is true and correct. Signature of Each Withdrawing Partner(s) ­ print name next to signature This statement was filed with the County Clerk-Recorder of Sutter County on the date indicated by the filing stamp in the upper right hand corner. I HEREBY CERTIFY THAT THIS COPY IS A CORRECT COPY OF THE ORIGINAL STATEMENT ON FILE IN MY OFFICE. DONNA M. JOHNSTON, COUNTY CLERK Rev. 01/2014 BY:_____________________________________________, Deputy American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS FOR COMPLETION OF STATEMENT THE INSTRUCTIONS BELOW ARE NOT TO BE PUBLISHED BUSINESS AND PROFESSIONS CODE SECTION 17923: (a) Any registrant who is a general partner in a partnership that is or has been regularly transacting business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 of withdrawal shall be executed by the registrant filing the statement in the same manner as a fictitious business name statement, excluding the requirements of subdivisions (d), (e), and (f) of Section 17913, and shall be filed with the county clerk of the county where the partnership filed its fictitious business name statement. (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 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 names and residence addresses of the registrant or registrants withdrawing as partners. (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 the 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. BUSINESS AND 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 ($1,000) (Business and Professions Code Section 17930)." These statements do not constitute a part of the fictitious business name statement and are not required to be published pursuant to Section 17917. (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. Rev. 01/2014 American LegalNet, Inc. www.FormsWorkFlow.com