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Affidavit Under Fictitious Name Statute
STATE OF FLORIDA
SS.
COUNTY OF ST. LUCIE
The undersigned, under oath, says: That he or she is engaged in a business enterprise under the
fictitious name of -COUGH-UOCJGFt DONUTS
7979 ST. LUCIE PLAZA
located at
. PORT T . ~ U C I E St. Lucie Coun ,Florida
m the City of tY
Those interested in said enterprise, and the extent of the interest of each, is as follows:
L~~e Its ~ 'v:l soy, I sac. 100`
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Proof of publication of this intention to register, is filed herewith, pursuant to the provisions of
i Chapter 20953, Laws of 1941. i
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-PRESI E"!T ~44
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1 DECEMBER '9 I
g Sworn to and subscribed before me this day of 19_____.
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ROGER POITRAS III
CLERK CIRCUf? COURT Notary Public
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~ By t ir_~_______ D.C. My Commission expires_________
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