APPLICATION FOR REGISTRATION OF FICTITIOUS NAME REGISTRATION Fictitious Name to be Registered: QUANTA COFFEE
Mailing Address of Business:2896 TENNIS CLUB DRIVE, APT. 307WEST PALM BEACH, FL 33417
Florida County of Principal Place of Business: PALM BEACH FEI Number: Owner(s) of Fictitious Name: QUANTA INVESTMENTS, LLC 2896 TENNIS CLUB DRIVE, APT. 307 WEST PALM BEACH, FL 33417 US Florida Document Number: L15000131289 FEI Number: Applied for I the undersigned, being an owner in the above fictitious name, certify that the information indicated on this form is true and accurate. I further certify that the fictitious name to be registered has been advertised at least once in a newspaper as defined in Chapter 50, Florida Statutes, in the county where the principal place of business is located. I understand that the electronic signature below shall have the same legal effect as if made under oath and I am aware that false information submitted in a document to the Department of State constitutes a third degree felony as provided for in s. 817.155, Florida Statutes.
MATEO HOYOS BEDOYA, MEMBER09/09/2015
Electronic Signature(s)Date
Certificate of Status Requested ( ) Certified Copy Requested (X) EFTA00151200