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Affidavit Under Fictitious Name Statute
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The undersigned, under oath, says: That he or she is engaged in a business enbrprise under the
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fictitious name of ----.~QLI2_~~?A,ST_RQOEINS'c--------------------------------------------
~ocated at __~au~c~c~--- Rt --4- B~?~----- 2~5 :
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in the Ciy of Ft._ Pierce L_ Fla. _ St. Lucie County, Fbrida
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Those interested in ssid enterprise, and the extent of ihe interest of each, is as follows: ~
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AOOEA POtTR~I:
CLERI~ ClitCU1T R1
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Proof of publication of this inte~tion to register, is filed herewith, pursuant to the provisions of ~
Chapter 20953, Laws of 1941.
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~ -------------------------------Si$ned _ Bernard_Worley_---------
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~ Swom to and suburibed before me this ____4th________ day of _____JSYIUBr~Y 19____?1
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~ ,.~;u,rir.;<<, CIRCUIT COURT Notary Public
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~ • ~ D.C. My Commission expires____________
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