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STATS OF FLORIDA ~
CAUNTY OF ST. LUGI~ ss: _
' e~toca ve peracnauy~:pp~rea WeLtoa Qulb~rth .aa ~ Liada Cutb~rth ,
hjs w~fe._ to oe well Icaowu and kaawp to me to be t6e individnals ~escdbed ia aod wba e:ecntad t6e faee~oin~--
~~~ad ackaawledged batoee ae th~t ~y t~scnted the same fa the pncposec t6ereia ezpc~essed.
~s lwrd ond efficial seal this da af ~na , 19 70~
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~,,;:.•K Notary Pub ~c iR a~d for tle cow~ a~~ State a/orsaaid
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T. ~~,~~~:°i ~y ~o~~,~ e:p~ ~?Prit 16, 1979
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8efore me perseaally ~ppeored ~ . to me -well lcaown d knam to me to
be tbe individual described in aad who e:ecuted the faegoing iastcument~ a~ acknawledged beface aie t~wt he
e:acuted the same fa the parpoaees tberein expcessed.
" ~iTpFSS my 6aod and official ~1 this day af . 19
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Notary Peblic as a~d ~or tl~e cow~tr aad State ajorasaid
My commissi ic~es
~ ~It~~ ANO RECORD p~
' S'f: LUCI~ COUNTY; f~?. -
~ RECORO VERIFt~p
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ROGER POITRAS ~ .
- - CLERK CIRCUIT COURT~
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7tiis t«. a~ be o.ea .r~ e?e .ec.ri~r • O'~) ~ T ~
isstniaeat~ i~ eoaaectio~ ~ritt~ iaort6aaes .
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~ed ia couectiop rret4 "iadi~ridul vart- -
~es" to be i~s~rad oader Sectiou 213. .
Z20. 221, Z33. 804 ud 810 of tre Natior
d Hoasl~ Act. ~ .
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