Lassen County, CA · Lassen County
Fictitious Business Name Statement and Instructions
This statement lets business registrants file a fictitious business name with the Lassen County Clerk and provides instructions for completing it.
At a glance
- Issued by
- City of Lassen County · Lassen County, Lassen County, California
- Notarization
- Not required: file this form without a notary.
- Official source
- lassencounty.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Use this form to file a fictitious business name statement or renew a registration with the Lassen County Clerk. It asks for the business name and address, registrant details, business type, commencement date, and signatures; the instructions also explain filing and publication requirements.
Who needs it
Business owners and other registrants using a fictitious business name file this statement with the county clerk.
How to submit it
The form lists the County Clerk at 220 South Lassen Street, Suite 5, Susanville, CA 96130. If mailing it, include a return self-addressed stamped envelope; the form notes an additional fee of $3 for each additional business name and registrant on the same statement at the same location.
About notarization
This statement is signed without a notary; the registrant declares the information true and correct, then signs and prints their name.
How to submit this form
- 1
Download the Form
Download the fictitious business name statement and its completion instructions.
- 2
Complete the Statement
Enter the business name and address, registrant information, business type, commencement date, and required signatures.
- 3
Gather Any Addendum
If listing additional business or registrant names, check whether an addendum is attached; the form says an addendum is available.
- 4
Submit to the County Clerk
Submit it to the County Clerk at the address shown on the form. For mailed filings, include a return self-addressed stamped envelope.
Frequently asked questions
- Do I need a notary for the fictitious business name statement?
- No. The form has signature lines and a declaration that the information is true and correct; it does not require a notary.
- How do I submit the fictitious business name statement?
- The form lists the County Clerk at 220 South Lassen Street, Suite 5, Susanville, CA 96130. For mailing, include a return self-addressed stamped envelope.
- What information does the statement ask for?
- It requests the fictitious business name, principal business address, registrant names and addresses, business type, commencement date, and required signatures.
- Does the form explain publication requirements?
- Yes. Its instructions describe publication requirements for original, new, or refiled statements, and explain when an expired statement must be republished.