FILE NUMBER: 2022-072
The fictitious business name was filed in Modoc County on November 18, 2022. The person(s) have abandoned the use of the fictitious business name(s):
Name of Business (es): Coffee Adventure, 22425 Hwy 299E, Canby, CA 96015. County: Modoc.
REGISTERED OWNER: (1) Shayla Derstine, 23510 Hwy 299E, Canby, CA 96015.
Business was conducted by: An Individual.
I declare that all information in this statement is true and correct (a registrant who declared as true information which he or she knows to be false is guilty of a crime).
SIGNATURE OF REGISTRANT: /s/ Shayla Derstine, Owner.
Print name of person signing. If corporation, also print corporate title of officer. If LLC, also print title of officer or manager. This statement was filed with the County Clerk of Modoc County on May 21, 2025.
I HEREBY CERTIFY THAT THIS COPY IS A CORRECT COPY OF THE ORIGINAL STATEMENT ON FILE IN MY OFFICE.
Filed by: /s/ Julie L. Ihrke, Deputy Clerk. Published in the Modoc County Record on May 29, June 5, 12 and 19, 2025.
STATEMENT OF ABANDONMENT OF USE OF FICTITIOUS BUSINESS NAME
