Filing No.: 2019-47-055
FILED: Siskiyou County
February 11, 2019
Colleen Setzer, Clerk
By: D. Daw, Deputy Clerk
Filing Fee: $37.00 - For first business name on statement.
$2.00 - For each additional business name filed on same statement and doing business at the same location.
$2.00 - For each additional owner in excess of one owner.
Fictitious Business Name Statement
The following person (persons) is (are) doing business as:
The Wild Sunflower, 315 Church St., Mount Shasta, CA 96067; Siskiyou County
Andrea Lynn Campbell, 315 Church St., Mount Shasta, CA 96067
This business is being conducted by: an Individual
The registrant commenced to transact business under the fictitious business name or names listed above on: N/A
I declare that all information in this statement is true and correct.
A registrant who declares as true any material matter pursuant to this section that the registrant knows to be false is guilty of a misdemeanor punishable by a fine not to exceed one thousand dollars ($1,000).
/s/ Andrea Campbell
Print: Andrea Campbell
This statement was filed with the County Clerk of Siskiyou County on date indicated by filed stamp above.
NOTICE – In accordance with subdivision (a) of Section 1792O, a Fictitious Business Name Statement generally expires at the end of five years from the date on which it was filed in the office of the county clerk, except, as provided in subdivision (b) of Section 17920, where it expires 40 days after any change in the facts set forth in the statement pursuant to Section 17913 other than a change in the registered owner. A new Fictitious Business Name Statement must be filed before the expiration.
The filing of this statement does not of itself authorize the use in this state of a fictitious business name in violation of the rights of another under federal, state or common law. (See Section 14411 et seq. Business and Professions Code).
I hereby certify that this copy is a correct copy of the original statement on file in my office.
COLLEEN SETZER, County Clerk
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