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~ffidavit Under Fictitious Name Statute
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STATE OP FLORIDA ~
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COUN7Y OP ST. LUCIE ~
The undarsigned, under oath, says: That he or she is engaged in a business enterprise under the ~
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fictitious name of J.S.R. Company
iocateci at 2~~4 ~~'~~3"~`-f°`~ Rl`~d, Room 508 Hollywood, Fla. 33020
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Bro~rd
in the City of ---------xS2~ly..S~CQDS1-------------------. ~ Florida
Those interested in said enterprise, and the extent of the interest of each, is as follows:
------~e~o~,e A_~im4ns ---=------5Q
Robert S. Simons ----------50 ~
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; Proof of publication of this intention to re9ister, is filed herewith, pursuant to ;na provisions of '
~ Chapter 20953, Laws of 1941.
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~ Aobert S Simane
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3=~ Sworn to and subscribed before me this day of ~r~°'`-----=::,,r.., 1971
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; ROGER POl7RAS ~ - ~--s~Y -
~ CLERK CIRCUIT COURT Not Public ~ -
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221'796 ~
~ D.C. My Commission expires__'~ '
% 8Y N1txY h1Gt. Si~t ~f florde at lYe1
``:y fi~EO aH~~ uEC ~~ED ~
ST.IU~~, ^:;~N~Y FLA. ~ r~paissiM e~Aira ~ioi2r S. 19iS
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REC09L ~
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BooK ~90 PAGf 1~`35 '
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