Florida Fictitious Name Registration and EIN Order Form

Application For Registration Of Fictitious Name

This is not the Application for a Corporation or a LLC.
If you are unsure about the Fictitious Name Registration, please call our office so a representative may assist you. 1-800-494-3124

Fictitious Name Information

Fictitious Name to be Registered:

Mailing Address of Business:


		City:

State:


		Zip Code:

Florida County of
Principal Place of Business:


		FEI Number (optional):

Contact Information (Required information)

Name:


		Phone:

Email Address:


		Yes, I would like to receive text & email alerts

Owner Information

Owner Individual Name

Owner Entity Name

First Name:

Middle Name:

Last Name:

Address:

City:

State:

Zip Code:

Florida Document Number:

		FEI:
(Only applies to Corporate or LLC owners)			(Only applies to Corporate or LLC owners)

FEI Number Status:

Applied For

Not Applicable

Current

Add Owner

Owner Individual Name

Owner Entity Name

First Name:

Middle Name:

Last Name:

Address:

City:

State:

Zip Code:

Florida Document Number:

		FEI:
(Only applies to Corporate or LLC owners)			(Only applies to Corporate or LLC owners)

FEI Number Status:

Applied For

Not Applicable

Current

Florida Fees and Services

Florida Fictitious Name (DBA) Registration: $165.00 Required

Prepare SS4 for Federal Employer Tax ID Number: $25.00

Your order is totaled automatically and provided below

ORDER TOTAL $