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Affidavit Under Fictitious 1`+Tame Statute
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STATE Off FLORIDA
SS.
COUNTY Off ST. LUCIE
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The undersigned, under oath, says: That he or she is engaged in a business enterprise under the
fictitious name of ~ -
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located at
in the City of ______~~'__~'~'c'_r'~ St. Lucie County, Florida '
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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, Laws of 1941. ~
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Sworn to and subscribed before me this day of _ ~~'!~-raj 19_7
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x; ROGER POITRAS
Nota Public
~ CLERIC CIRCUIT COURT N
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g _ D.C. My Commission expires___________________ t
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