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Enter the complete street address, city, state and zip code of the LLC's principal office. Review the instructions for filing a fictitious name registration.Gather all information required to complete the form. Your full name and date of birth: Valid, Unexpired U.S. passport. Valid, Unexpired U.S. passport card. FBN Statement information; Credit card information. Once everything is completed a copy will be mailed out to the address provided. All mail requests must include a completed Fictitious Business Name Statement and a notarized Affidavit of Identity form. Norwalk Headquarters. Complete item 13 in accordance with instructions on Amendment Addendum (Form UCC3Ad).