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PRINT YOUR NAME PRINT YOUR FICTITIOUS NAME (D/B/A) OR (2) I do not have to comply with the Fictitious Name Act because: Check Appropriate Box I AM USING MY FULL LEGAL NAME MY BUSINESS IS REGISTERED AS A CORPORATION OTHER FAILURE TO COMPLY WITH THE FICTITIOUS NAME REGISTRATION PROVISIONS OF SECTION 865.09, FLORIDA STATUTES, IS A MISDEMEANOR OF THE SECOND DEGREE AND PUNISHABLE AS PROVIDED IN SECTION 775.082 OR SECTION 775.083, FLORIDA STATUTES.I UNDERSTAND THAT BY SIGNING THIS FORM, THAT IF ANY OF THE ABOVE IS NOT TRUE, I WILL BE GUILTY OF A MISDEMEANOR OF THE SECOND DEGREE..
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