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Affidavit UndeY Fictitious Name Statute
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STATE OF FIORIDA
SS.
COUNTY OF ST. LUCIE
The undersigned, under oath, says: That he or she is engaged in a business ente~prise u~der the
fictitious name of ~/Q//~!1~~ ---~'-~AR~E~S------------------------------------
Ixated at _.__---~~-F---~ ~.~N~E -
in the Ci of ~~JCC~--------------------, St. Lucie County, Florida
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Those i~terested i~ said enterprise, and the extent of the interest of each, is as follows:
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-~.~,,,.i 1_~ --~_-~~.'~nns_Qt~ - '-~-oO-~'-------------------------
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` Proof of pubtication of this intention to register, is filed herewith, pursuant to the provisions of ~
j Chapte~ 20953, Laws of 1941.
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Sworn to and subscribed before me this ____Jr------- day of 19!
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ROGER POITRAS
~ CLERK CIRCUIT COURT Notary Public
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~ :~'1 •~rC tJ?____________ D.C. My Commission expires____ ~
~ BY ~--:-,zr; - f` L~0 ~flG RECOA~E0 ~
~ • - iT LUCIE COUNTY FLA. ~
~ ~ ~ ROCER %OiTAAi ~ ~
. CIfRK L:RCUIT COURT `
~ ` RECORD YERIfIED~ ;
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