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Affidavit Uader Fictitious Na~e Statute
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The undersigned, unde~ oath, says: That he o~ she is engaged i~ a business anb~prite ur?der the
fictitious name of ~H~IICS-CS1A'C~SLD-~-aSSISTJNCB~~~-----------------
2905 A~e D `
located at
in the City of -~•_~elQe St. lucie County, Florida
Those inte~ested in said ente~prise, and the extent of the interest of each, is as follows: ~
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ltrs Bersice Crntchiield ____________100 ~
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Proof of publication of this intention to register, is filed herewith, pursuant to the provisions of
Chapter 20953, Laws of 19d 1. ~
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Sworn to and subxribed before me this __14th_____ day of ~lY________, 19____Tl
ROG~ POITRAS
CIERK CIRCUR COURT ~ -{+lotary Pubtic
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y!~~~~ ~ - D.C. My Commission expires ~
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