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Affid~vit Under Fictitious 1~Tame Statute
STATE Of FLORIDA `
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SS.
COUNTIf OF ST. LUCIE
The undersigned, under oath, says: That he or she is engaged in a business ente~prise under the
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fict:tious name of _t~
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locaied at _~t/~~~~ _ Q~~ ~--~w~---------------------------------------
in the City of __J_..~PJ'Sf St. Lucie County, Fiorida
Those interested in said enterprise, and the extent of the interest of each, is as follows:
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~ Proof of publication of this intention to register, is filed herewith, pvrsuant to the provisions of
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~ Chapter 20953, Laws of 1941.
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Sworn to and subscribed before .me this day of ______~!!~!I ~'Sr________, 19~ L:
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, ~Ip1Ci~~ POITRAS }
~ Notar Public
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- :;8y ~ : D.C. My Commission expires___________________
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a~207 ~ 8i9
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No. 10