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Notice Under Fictitious Name Law

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According to Florida Statute Number 865.09
NOTICE IS HEREBY GIVEN that the undersigned, desiring to engage in business under the Fictitious Name of

located at (Address of Business) in the City of
County, State of (Zip Code)
intends to register the said name with the Division of Corporations of the Department of State, Tallahassee, Florida.
Dated at Jacksonville, Florida, this day of , .
(Business Owner)
(If incorporated, name of Officer of Corporation)
The above notice is to be published one time in The Daily Record. Cost of one time advertisement is $30.00, which includes proof of publication.
Proof of publication will be mailed to the address below.
Enter the name and address where the proof of publication should be sent.
Company:
Contact Name:
Address:
City:
State: Zip:
Phone Number:
E-mail Address:

Credit Card Information
Credit Card:
Expiration: (MM/YY)
CVV2 Security Code: What is this?
Name as it appears on card:
Zip:
The zip code where the credit card billing statement is sent is required for security purposes


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