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IN ~?ITNESS ~HEREOF. the said matgagor has heceunto set his hend end sesl the day and year first afoce-
said.
Sig~ed, sealed, d de ivered ' the presence of- _
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STATE OF FLORIDA }
COUNTY OF 8'1'. ~Ia ss: ~
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Before me pe;sonally appeared 1iTilliaia end C'baT1p~ ~j. ` e,;e,:.,,,, ~
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his wife. to me well known and known to me to be the individuals described in end who e:~;:~~-.. ~s.N;~~i•yis
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instrumeat, and aclwowledged before aae that they executed the same fa the purposes therein e--~: ;::.•.~'n
wl'fNESS my hand and officiel seal this 1~h da MstCb Y~ a
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Notary Public nd ~or tJ~e county ' . -
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My commission expires ~ ~~j ~j~ ~ Y~ ~
STATE OF ss:
COUNTY OF
Befoce me personally appeared , to me well knawn and known *o me to
be the individual described in and who e:ecuted the foregoing instrument. and acknoaledged befoce me that he
executed the same for the purposes therein expressed.
~1TNESS my hand and officiel seal this day of . 19
Notary Public in and /or tht county and State a foresaid
My commission ezpites ~
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FILEO AN~ RECOaO~D~
ST. lUC1E COUNTY. FLA=
p~~^ 191~~
,
i 'i0 MAR I 9 PM i 8
R FdITRAS
This form may be used as t6e sec~aity R~GE
instrument in connection with mortgages OLERK CIRCUI7 COUaS~ ~
w be insnred ander Sections 203 and 222, ~
and ia connection wit6 "individaal mort- ~
ga6es" to be insared nnder Sections 213, ~
220, 221, 233, 809 and 810 ot t6e Natioo- ;
al Housina Act. '
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