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AFFIDAVIT UNDER FICTITIOUS NAME STATUTE
STATE OF FLORIDA ) _
COUNTY OF PALM BEACH )
The undersigned, under oath, says; It is the intention of the undersigned to engage in e
business enterprise under the fictitious name of VILLAGE BOOTERY
Iclcated at c/o 1224 U S. Hij~hway Ogle, North Palm Beach, FL 33408
in the City clf Fort Pierce St. Lucie County, Florida.
These interested in said enterprise, and the extent of the ' rest of each, ' a ollows:
Print or type name Interest
PARK SHOES , INC . , a Fla . core . Signature.
Thomas C. Schue>nann, President Park a ue .
Address
Robert B. Schuemann, Vice-Pres. Signatur "
ar venu
Address
Milton Schuemann Signatu
ar venue
Address
Swcrn tcl and subscribed to before me, at~~T~y ,this ~ _
llav (1~ , 19 yyr,, ~
1, ~
Notary Public, State
RaMrY Pubic, : e ° s
My Commission_E~y ~t#dt
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j Proof of publication of thb intention to resbter. V Akd herewiW. .
punuant to the pro~bioa~ of Chapter 20!.51. Irws d 1l41(JliS.0! FSA)) ~ -
~ ATTACH PROOF OF PUBLICATION "
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1 THIS INSTRUMENT PREPARED BYf
~ RICHARD G. OYTRYC.N
1224 OLO PORT COVE "LAiA
P. 0. BOX 14266
NORTH PALM BEACH, fIORIDA 3308
ej~3~31 PEE 243 - .