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Please check that information is exactly as shown on your filed form.
Filing Information
County in California where DBA was filed
Not Selected
ALAMEDA
ALPINE
AMADOR
BUTTE
CALAVERAS
COLUSA
CONTRA COSTA
DEL NORTE
EL DORADO
FRESNO
GLENN
HUMBOLDT
IMPERIAL
INYO
KERN
KINGS
LASSEN
LOS ANGELES
MADERA
MARIN
MARIPOSA
MENDOCINO
MERCED
MODOC
MONO
MONTEREY
NAPA
NEVADA
ORANGE
PLACER
PLUMAS
RIVERSIDE
SACRAMENTO
SAN BENITO
SAN BERNARDINO
SAN DIEGO
SAN FRANCISCO
SAN JOAQUIN
SAN LUIS OBISPO
SAN MATEO
SANTA BARBARA
SANTA CLARA
SANTA CRUZ
SHASTA
SIERRA
SISKIYOU
SOLANO
SONOMA
STANISLAUS
SUTTER
TEHAMA
TRINITY
TULARE
TUOLUMNE
VENTURA
YOLO
YUBA
Type of Filing
Original Filing
File Number
File Date
County Clerk's Name
(If available)
Business Information
Business Name(s)
1.
Business Address (PO Box / PMB address NOT acceptable)
AL
AK
AR
AZ
CO
CA
CT
DE
FL
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HI
ID
IL
IN
IA
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KY
LA
ME
MD
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NY
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OR
PA
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DC
-
Business County
Select Business County
ALAMEDA
ALPINE
AMADOR
BUTTE
CALAVERAS
COLUSA
CONTRA COSTA
DEL NORTE
EL DORADO
FRESNO
GLENN
HUMBOLDT
IMPERIAL
INYO
KERN
KINGS
LASSEN
LOS ANGELES
MADERA
MARIN
MARIPOSA
MENDOCINO
MERCED
MODOC
MONO
MONTEREY
NAPA
NEVADA
ORANGE
PLACER
PLUMAS
RIVERSIDE
SACRAMENTO
SAN BENITO
SAN BERNARDINO
SAN DIEGO
SAN FRANCISCO
SAN JOAQUIN
SAN LUIS OBISPO
SAN MATEO
SANTA BARBARA
SANTA CLARA
SANTA CRUZ
SHASTA
SIERRA
SISKIYOU
SOLANO
SONOMA
STANISLAUS
SUTTER
TEHAMA
TRINITY
TULARE
TUOLUMNE
VENTURA
YOLO
YUBA
Business is conducted by
an Individual
a General Partnership
Joint Venture
a Trust
Co-Partners
a Married Couple
a Corporation
a Limited Partnership
an unincorporated association other than partnership
a limited liability company
Other
State or Local Registered Domestic Partners
a Limited Liability Partnership
Not Known
Please select one of the following for Business start date:
The registered owner commenced to transact business under this name
on:
The registered owner has not yet begun to transact business under this name.
Did you enter a mailing address on your filed form?
Yes
No
Registered Owners:
1.
First, Middle and Last Name
Copy principal business address here?
Business Mailing Address (PO Box / PMB address NOT acceptable)
AL
AK
AR
AZ
CO
CA
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
-
Signer Information
Name of person who signed the filed form
Contact Information
Name
Copy principal business address here?
AL
AK
AR
AZ
CO
CA
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
-
Email
I checked information and it is matching as filed on the form with the County of ALAMEDA.
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