Select the county where your principal place of business will be located.
Business Address for Fictitious Name
Address where your principal place of business is located
Any address in the United States can be used including a post office box.
Owner Name And Address
(Corporation, LLC, etc.)
Owner # 1
Add Additional Owner
If the billing address you enter does not match what
is on file with your bank, the charge will be declined and appear as “PENDING” on your
banking account. Your banking institution policy will determine how long it takes
before the “PENDING” status will be automatically removed from your account.
The charge will appear on your credit card statement as “Business Name Publishing”.
I the undersigned, being an owner in the above fictitious name,
certify that the information indicated on this form is true and accurate. I allow Florida Fictitious Name Publishing
to file the above information with the appropriate state agency, under my name. I understand that the electronic signature
below shall have the same legal effect as if made under oath and
I am aware that false information submitted in a document to the Department of
State constitutes a third degree felony as provided for in s. 817.155, F.S