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~ ~tatt of .~ort~j 4~aroli~a
~Coaatp of ~ui[forb
~~crc~p lCtrtifp tbrt oK tbis d.y persondly sppesr~d before ~n~, sn o~'icn duly
outborized to ad»~ixisttr artbs end tskt scknowltdgmtnt, Charlea H. Rivea~ Jr•
Vict-P~esidtnt of Je~t~son Stsnd~rd Life Insttronct Compsny, t corporttion to mt w~11 known
to be tb~r iadi~vidxel end o~f'ictr of sad corporation dtserilxd in snd wbo exeexttd tbr for~going
utisfectiou piuce ond dxly icknawltdgtd lxfore me tbat said corporatiohe execr~ted tbe same for
tbc purposes tber~in exp~ess~d as tbr ~et ~d dtad of said corpor~tion.
~n ~itnegg ~~jereof I bove btreunto set my brr~rd and a~''ixed my officiol seal at ~
G`~ehesboro, said County snd Ststt, tbis 2 9 th day o
f
A. D. 19 6? ~
December ~ +
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- Notary Pnblic
AIY COMIIAISSIOW EXPIRES SEPT. 1
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FIIED AND RECOROED _
ST.R
U~~~~ VERIFIEDLA.
.t6332`7
'~8 JAN 8 AM 10 : 39
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:~O~i_i< r'UfTR.•
CLERK CIRCUI'f COURT
600K ~V~7 PACE~7~
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