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. ~ ~ i I E . TtiIS F1NAlKIt~KK3 STATEMENT is p..s.wnd a o tili~q offic.r for filiny ~wrsuoM a eM Unifonn Cowi...dol Cod.: 3. IMoto.iH daa (if mr): 1. D~Me?ly (loq Nowr F'aa11 and oddreu(~s) 2. S~cvnd ?arh(i~s) ond oddr~ss(~s) rILCUrA1VU K~~~~ ~ 5~~~ ~~r~ ST. LUCIE COUNTY. FLA.~ z Pa~tn, Job C. 3312 Ora~ga ir~. R E- ^ n~ ~ R! FIE D ~ 1403 Zorth 35th St. lhrt Pi~, tlorida ~~or.4~Z~' r~'art Pi~s~os, ~'la. 3345a . 3345~ '68 APR I~ AN 9: 3 0 ~ ~ 1. lhia fiwawtin~ sMNw~M ce~s Mr foqowinY hiP~s (or it~ws) ef P~M~I~= 1~~0 Ts~ jtivi~ra 1T ?t. H~at S~r. ~t537 ~ ~nrraJ Y16D '1'rail~! S~ri.al ~20806 i~U;,:=?Z i-OITRAS = 1969 6S YP Marnd~ li~tor~ Ifodsl ~f 5O53e S. bsi~(s) of S~cw~d ~s) ~ 3~Z'lil ~02~11 ST. tUdE OOUNn BANK ~ ~ P.QBOXB ~ ~ b. c~ ~ n~. .+..v. ..w~••e sr c~ ao~, ~.s. e... v~«.a w~a.,«r ~•,•,~«w. ..~..a FORT PIE,RCE. fLOR1QA 3 3 4 a T # ba.br. «a wip b. ~lao~ aw~r oddtiond me .i~wib. in.n~w~w/ d+~1 .q,, e. .o ..a,..a. Y This sta~ww~wf b fiNd ~r'dhwl /M d~bler's si~nnatw~ fo pwf~ef e wcxib iiM~r~at In oollo~wol. (CMck ~ N so1 ~ Q AMwdr s~M N e s~wiry inhr~st is ane1AM ~k~Ction wMn it was barolA iMe N~ stoN. .rt~ .~r~ . ? vrhkh b precMds of Ilr eriyind ceNohrd dacrib~d ~bov~ iw ~rhid a wairify iMrrsf wos P~K~= ~ Yi - ~ = CMck ~ N cov~nd: hoa~d~ ef Co1loHrd an ahe oov~nd. hodYds ef Colldwd on dso cmr~ad. Ne. of addiNond SMets w~N~:. ~ ~ Fil.d wnh: $tr• LqR1! CiOM1, ' ' • ~ _ r i _f ~ _ ? ? $ Ci~~1' ~ ~f r - ` r• f . d ~ ~ ~ ~r W~ ' sionow..tsl ef o~b~«tsI Spno~~i ~r( i STANDARD FORM - FORM UCC-1 600K ~ • ~ r~ F~ ApproHd b! Taw Adonn, S~cr~ta.r of Sfah, Sta~ oF F{uida ~ , T ys~~-, 3 . - . _ _ - - ~ ~~:,,u ~ " s7;~-,,., - ~.s-: _ . . , '..~:s:s