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HomeMy WebLinkAbout2067.. .___ _ ~ - . _ ~~ . - z ~ 1`ttw 66t U. S< T~EASUIl1f DEPARTMEN[, - WrERNAI lENRrt1E SElVtCE Wr 4~sw ~ y' ~.nsi~ t3Aln 66) ~ ~ ~~~ ~ ~ T~ V~ V 1 . (RE . D15T1tlCT SER1At ~ MtM~ _ . _ ,~ b wN© REC . ;_ ,~~~~ ST LUCIE COUN bRD VERIFI~D EC ~ hstiby aati[jl that os to tlas iollowinp•nontsd to:poyar tlhs arq~airaannts of Sst~tott 6325(0), to ala.- na.aoad below > b Nti h 1 p , o~ «au l aMtxnal ttraa~ Cod., how b.«, totisfNd wit ~ with otl ,tat„>a,- addlllans P~'oridad by S.alott 6nit «.d that tla. Ilan foi a,da tmoss h rfi ~- ~~; I 0 EP op. o. w addition. has thsr~by b.a1, .d.as.d. Tits prep.. a~« in >M o . intornol twtpna. toac Ilan was fill an April 18 . 19 69 . h h.r°6y' ~ ouNarlsd w make nowtaon on his books b slaonr flee nlwss of said list4 iraofar oa the heat ROGER ~OiTRAS `~O'~`1Otl'~ ~~a'M~'°'~` RK CIRCUIT COtlRT! NAME OF TAIV/I1fER. Its ~~ v ~ ~~~ iii QA36 CF TAX UNMID WAt~ (Teat plum Form No.) PERIOD ENDED /-S6E~NT DATE IDEi~RIFYiN3 NUMBER OF A56B6MEt~IT bl (b) Id Wl NI ~~'h ~~~ Pi/10F OF RUNG j~ ~~, TOTAL = ~t ~ t~s~ WITNESS try hand of Jacktsonvill,e, Florida ' on tfii:, tfie and ~y of ~.,At.aa.~.~ ,14.6E SIGNATURE TITLE IEF, SPECIAL PROCEDURES SECTION p4o~rE: Certl of offiosr awhortzd by low b take odmowLdpansnts a na ssataMid to th. voliditya~ ~~ ~.C.M_ 26419. C.4 1950.1, 1Z ~'~ s. PART 3-Te be used for nsordtn6 Purposes +'"~`'"~ _~ <~