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Affidavit Under Fictitious Name Statute
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The undersigned, under oath, says: That he or she is engaged in a business enterprise under the
fictitious name of ------------SI~SS~_~.a$4Y~S-------------------------------------------
Midway Road
located at
in the City of Ft. _Pierce St. Lucie County, Florida
Those interested in said enterprise, and the extent of the interest of each, is as follows:
Sal Falciglia ___50 percent_____________
___Charles_W._Cole__________________ ___50_percent_____________ _
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Proof of publication of this intention to register, is filed herewith, pursuant to the provisions of
3
Chapter 20953, Laws of 1941.
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Sworn to and subscribed before me this day of ~L!~! ~ ; t
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Y ROQER POITRAS -----------------------ss,r._~~:.----~~,~
_ CLERK CIRCUR COURT Notary Public •+?+~t~-c~.:~~'` s
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BY D.C. My Commission expires----x~'' ~~Y~~i_ ~ ~~'t
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~~304 X1096
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