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fi~eo ~NO RECo
AFFID~IVIT UNDER FICTITIOUS ST~TUTE ~uc~E couMnr~.
ROCER PAITItu
C~~RK CI~CWT~
9lECORD VERif'tEg~~
STATE OF FLORIDA SS Zl ~ 2.~'N'tI ~
COUNTY OF 5 t. l. ut ~ 212892
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The undersigned, under oath, says. It is the intention
of the undersigned to engage in a business enterprise under
the fictitious name of ~,r, ~,~~,r?/n~,~)
located at ~~C/. i/l. y~ ,o~~, in the city i
z
or ~
i. ~~Sr~ , S~ L u~ ~ e `
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County, Florida. '
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Those interested in said enterprise, and the extent of ~
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; the interest of each, is as follows:
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Print or T~rpe Name(s) (Amount of Interest in Enterprise)
~ N~~.. t~ .--,I~,1~ u S~ .v / Uc ~o
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Proof of publication of this intention to register, is
filed herewith, pursuant to the provisions of law.
~A~fix Signatur s) (Address~
f~ (t +.~r .~e
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Sworn to and subscribed to beforP me, at
, this ~~day of cJ~.v ~
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otary ic State o : '
~ ~or~?sr rusuc st~? o!
My Commission rB~~N ~ .MN4.•~'
This affidavit to be recorded with Publishers' Proof of Publicat~+o~`n k
in the office of the Clerk of the Circuit Ceurt. 3_y.;'S ~
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