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1 Mroby oe~Nfy this to be a true and corr+ed copy of the t,ocal RepMrar's record on file in the St. lode County Health Depart. ment at Fort Pierce, Flo-id~. (1Narning: hat vatid.urwei'raised seal of ths`St, lode County H~abh' De,~artrrppt b affixed) . ±' : - ~ •, s ;: Govnjy'~e~th aff.cer~ b local Registrar ~. ~ ~.~-- FILED ANO RECORDED ST. I.UCiE COUNTY. FIA. RFCQRO VERIFIED 183(10! '69 SEP i S PM !2:21 ~~ ROGEP, POITRAS CLERK CIRCUIT C©t~T' dooK179 ~~E26G9 -:~