The registrant of a fictitious business name may withdraw its registration by delivering to the Secretary of State a statement containing the following:
The legal name of the entity utilizing the fictitious business name;
The fictitious business name with respect to which the statement of withdrawal relates;
That the entity will no longer transact business in this state under the fictitious business name;
An acknowledgement that the applicant understands the fictitious business name registration will no longer be effective upon the filing of the statement of withdrawal; and
The signature of the withdrawing registrant.