CCRC staff is gearing up for the 2018 open enrollment period, which begins on November 1. There are many important changes to the Affordable Care Act (ACA) that will take effect this year, so we want to make sure that everyone is aware of their options and how to enroll. In this blog post, we will provide an overview of the key changes to the ACA for 2018, as well as information on how to get help enrolling in a plan. Stay tuned for more detailed posts about each of these topics in the coming weeks!
| Question | Answer |
|---|---|
| Form Name | Form Ccr Ckl 05 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | fictitious name form ventura, california ccrckl form template, ca ccrckl fictitious name search, california ccrckl ventura |
MARK A. LUNN
Ventura County Clerk and Recorder
800South Victoria Avenue Ventura, CA
STATEMENT OF ABANDONMENT OF USE OF FICTITIOUS BUSINESS NAME
Return Mailing Address
Name:
Address:
City: |
State: |
Zip Code: |
See reverse side for instructions
1.Submit original Abandonment with original signature(s)
2.Filing fee $39.00 plus $10.00 for each additional business name.
3.Mail a check or money order to the address above. Provide a self addressed stamped envelope.
THE FOLLOWING PERSON(S) HAS/HAVE ABANDONED USE TO THE FICTITIOUS BUSINESS NAME
Fictitious Business Name (s) (Business name being abandoned) |
(Type or Print Legibly) |
1________________________________________________________ |
2 __________________________________________________ |
__________________________________________________________________________________________________
Street Address of Principal Place of Business |
City |
State |
Zip Code |
The date on which the fictitious business name being abandoned was filed:
The file number to the fictitious business name being abandoned:
The county where the fictitious business name was filed:
__________________________________________________________________________________________________
Full name of Registrant (Individual)/ Corporation/Limited Liability Company
__________________________________________________________________________________________________
Residence Address (P.O. Box or PMB are not acceptable)City State Zip Code
___________________________________________________________________________________________________
Full name of Registrant (Individual)/ Corporation/Limited Liability Company
___________________________________________________________________________________________________
Residence Address (P.O. Box or PMB are not acceptable)City State Zip Code
___________________________________________________________________________________________________
Full name of Registrant (Individual)/ Corporation/Limited Liability Company
___________________________________________________________________________________________________
Residence Address (P.O. Box or PMB are not acceptable)City State Zip Code
THIS BUSINESS IS CONDUCTED BY: (Check one only)
( ) an individual |
( ) a general partnership |
( ) a limited partnership |
( ) a limited liability company |
( ) a trust |
( ) an unincorporated association other than a partnership |
( ) a corporation |
( ) copartners |
( ) husband and wife |
|
( ) joint venture |
( ) state or local registered domestic partners |
( ) limited liability partnership |
|
|
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.)
REGISTRANTS/CORP/LLC NAME____________________________________________________________________ TITLE__________________________________
REGISTRANT SIGNATURE__________________________________________________________________________________________________________________
If corporation, also print corporate title of officer, If LLC, also print title of officer or manager This statement was filed with the County Clerk of Ventura on the date indicated by the file stamp above.
CCR CKL 05 REV. 09/2010
INSTRUCTIONS FOR COMPLETION OF STATEMENT OF ABANDONMENT OF FICTITIOUS BUSINESS NAME
Please Type or Print Legibly
The instructions below are not to be published (Sec. 17924 B&P)
Section 17922 Business and Professions Code
17922 (a) Upon ceasing to transact business in this state under a fictitious business name that was filed in the previous five years, a person who has filed a fictitious business name statement shall file a statement of abandonment of use of fictitious business name. The statement shall be executed in the same manner as a fictitious business name statement and shall be filed with the county clerk of the county in which the person has filed his or her fictitious business name statement. The statement shall be published in the same manner as a fictitious business name statement and an affidavit showing its publication shall be filed with the county clerk after the completion of publication
(b)The statement shall include:
(1)The name being abandoned and the street address of the principal place of business.
(2)The date on which the fictitious business name statement relating to the fictitious business name being abandoned was filed, the file number, and the county where filed.
(3)In the case of an individual, the full name and residence address of the individual.
(4)In the case of a husband and wife, the full name and residence address of both the husband and wife.
(5)In the case of a general partnership, a limited partnership, copartners, a limited liability partnership, a joint venture, or an unincorporated association other than a partnership, the full names and residence address of all the general partners.
(6)In the case of a corporation, the name and address of the corporation as set forth in its articles of incorporation on file with the California Secretary of State.
(7)In the case of a trust, the full name and residence address of each of the trustees.
(8)In the case of a limited liability company, the name and address of the limited liability company as set forth in its articles of organization on file with the California Secretary of State.
(9)In the case of a state or local registered domestic partners, the full name and residence address of each domestic partner.
Check the box that best describes the nature of the business.
.
Notice to Person(s)
(1)Your Statement of Abandonment of Use of 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 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 conducted. (Business and Professions Code Section 17917).
(2)Any person who executes, files or publishes any 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 ($1000),
(Business and Professions Code Section 17930).
CCR CKL 05 REV. 09/2010