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Affidavit Under Fictitious Name Statute ~Q~~
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~ STATE OF FLORIDA
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COUNTY OF ST. LUCIE
The undersigned, und r oath, says: That he or is engaged in a busineas enterprise under the
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fiditious name of
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located at '
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in the Cify of ~~Gl~% ~~'~~--%'~t. Lucie County, Florida
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T interested in said en rprise, and the extent of the interest of each, is as follows:
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Proof of publication of this intention to register, is f'iled herewith, pursua~t to the ov'sions of
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! Chapter 20953, Laws of 1941. r
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~ Sworn to and subscribed before me this day of Q~~'~~~
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ROGER POfTRAS
" CLERK CIRCUIT COURT Notary Public
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