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Affidavit Un~er Fictitious Name Statute
STATE OF ~LORIDA
SS.
COUNTY OF ST. LUCIE
The undersigned, under oath, s~ys: That he or she 6s engaged in a business enterprise under the
fictitious name of ___I~s1tChC0_~.QYI::: a 11C~.QIL ~OIQk2dIL1C______~_______~__
located at __322.~o1~theast._Tr na ~i la_AY.en11e-------------------------------------
in the Ciy of .___p.Ar~-5~~.~1e_______________, St. Lucie Counfy, Florida
Those interested in said e~terprise, and ihe extent of the interest of each, is as follows:
A~]~~X_ P.._ Ha~~h-------------------- 104- .
Proof of publication of this intention to register, is filed herewith, pursuant to the provisions of
Chapter 20953, Laws of 1941. ,
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Sworn to and subsuibed before me this day of 1~,~9~~~.~'f
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RWGI POITRAS ~'V'R~Y~~ ~ ~
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CLERK CIRCUR COURT otary Public = . ' ' ` ;
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aY D.C. My ~ommission expires__ ~"17b~~~_
600K 2i1 rac: ~510
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