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. (l\V ~ 457669
AFFiDAV1T UNDER FiCI1TI0U3 NAME STATUTE
~~SyyT~~ATB OF FLORIDA u.
~.V OF aS~r ~ T.nni a
0
Tha uadessijned, undar oath, lays; It is the intention of the undersigned to engage is a
bwiaea enterprise under the fiCtitiOW name Of t~1An
Co-nner~ative' Inc_
lOCited at 3255 South U S 1,
in the City Of
F_, rce, FL s St. Lucie County, Florida.
Thole interested is said eaterpri:Q, and the extent of the interest of each, is as follows:
Print or type acme I e t
NAQP Co-op, Inc. Signature rs ~ "
Address F 33450
Signature
Address
_ Signature _ _
Address
Sworn, to and subaeribed to before me, at Ft • Pierce. FL ,this 7th
day of , 199.
h~~ ~ '
: ` ~ ~ Notary Pub 'c, State of Florida at I,ar~e
i~ ~"y , ~ ; ~ Notary Public. State of Fiarida At Larga
..a ~ • .
S.p~ ~ ~ } ~a~ , _ ? My Commission Expires My Commizsion Exaires Mar. 22, 1981
+4i ,y• BOndld By Heurre IneuranC~e C0.
[i~'~t~~~~'~j~~ .d.. N rn~.Mr.•i aM/ a~..Yr. ~.n...t M i~ ~..w... of cl.~ Z~. Laws K Is~~ (af6.8! FsA)1
F: ~ "t: « t` A AQ! !'ROOf Qf !U>ti1S:A710N _
TH E N EI~IS'FR RUNE ~Y~-- ~
Published Daily and Sundsy--,Ea+wl.i>tlyrday
ii Fort Pierce, St. Lucie County, Fbrida ~y
j STATE OF FLORIDA r
COUNTY OF ST. LOCI E
Before the undersigned authority personally appeared 19T9 SEP -7 P!~ ? y g
Marvin DeBolt or Kathleen K. LeClair, who on oath says that
he/she is Publisher, Publisher's Secretary of The News li ~~rit: ~co
Tribune, a daily newspaper published at Fort Pierce in St. ~ P°~'T~"'
Lucie County, Florida; that the attached copy of ad-
AEt~RO VERIFIED _
vertisement, being a f _
in the matter of co-operatwe:.~'
in the .....................Court, ~r_° ~i~~ oivi:~c~;
- - : j
_ .
was published in said newspaper in the issues of............ -
_ i?r: rte,
7/17,24,31 & 8/7/79
Affiant further says that the said News Tribune is a newspaper published at
Fort Pierce. in said St. Lucie County, Florida, and that the said newspaper has _ , y4,,; _
heretofore been continuously published in said St. Lucie County, Florida, each
day except Saturday and has been entered as second class mail matter at the
post office in Fort Pierce, in said St. Lucie County, Florida, for a period of one
year next mg the first publication of the attached copy of advertisement;
further says that he has neither paid nor promised any person. firm
r~l~,~ny discount: rebate, commission or refund for the purpose of
bftiscment for publication in the said newspaper.
y O to~apd ~ bed be[ore me
_ ; T ,t~: ~t•. day of it
, . , t-.~~ 8315 ~~~~!~p
- ~ NOTARY ?IMiC STATE Of fICfRIDA AT LARGE
. z _ MY COMMISSION EXPIRES . DEC_ 1 3 19 70