Fictitious Name - Florida Legal Online

Name:
E-mail:
Address:
City:
State/Province:
Postal Code:
Phone:

1) Relationship with the New Business (i.e. owner, officer, employee etc)


2) The Mailing Address for the Corporate Documents (if not being picked up at our office)


3) Fictitious Name to be registered (First Choice)


4) Fictitious Name to be registered (Second Choice)


5) Fictitious Name to be registered (Third Choice)


6) Principal Address of New Business
Address:
City:
State/Province:
Postal Code:

7) Mailing Address of the New Business (if different from Principal Address)
Address:
City:
State/Province:
Postal Code:

8) Please list the Names, Addresses of Owners For Individual Owners: First Name, Last Name & Middle Initial. For Business Owners: Entity Name, Florida Document Number, EIN & Status of the EIN (whether applied for, not applicable or current). For example: John E Smith, 1234 NW 56th Ave, Miami Florida 78910 Corporation Inc., "###FLADOC###," "###EIN###" EIN is current, 1234 NW 56th Ave, Miami Florida 78910


9) Confirm that the first owner listed full knowledge of this incorporation and grants the person requesting and this Firm permission to sign the corporate documents as necessary for the filing of the same.
I understand, agree and hereby certify that the information above is correct.
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