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,ka~i 13 I vi PH'73
256'70'7
Affidavit Under Ficiitious Name Statute
STATE OF FtORIDA ;
SS. ;
COUNTY OF ST. LUCIE
" The undersigned, under oath, says: That he or she is engaged in a business enterprise urtder the
fictitious name of _ _ r ' ^ ~
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located at _
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in the Ciy of St. Lucie County, Florida
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, pursuant to the provisions of
Chapter 20953, taws of 1941.
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Sworn to and subscribed before me this _ _ _ _ _ _ _ _ _ _ day of _ _ -~~-z~ _ _ _ _ 1 q7 3 ,
ROGER POfTRAS
CtERK CIRCUtT COURT Notary Public
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Y D.C. My Commission expires----_-----_--------
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