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Get CA CCR CLK 04 2011

Ddress Registrar-Recorder/County Clerk's Filing Stamp Name: Address: City: State: Zip Code: See reverse side for instructions 1. Submit original FBN with original signature(s) * 1A 2. Filing fee $53.00 for the first business and owner name plus an additional $10.00 for each additional business name and/or owner name on the same statement. 3. Mail a check or money order to the address above. Provide a self addressed stamped envelope. THE FOLLOWING PERSON(S) IS (ARE) DOING BUSINESS AS: 1* .

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