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~..~..wa..~..--~~s_--~'*7+-~? ~ T" - - _ . .r~......,_ ~ . ~ 1~ ~f,~~y , ~~~t ~ ~ . , . _ y • _ y ' . a- t:'r =s:'k~:_ '~.s• ' j: _ , . a. ! I • - • ~ ~ ' ' • , • • ` . _ 4Nw11M b t~Or~ ONii~ hew ~N U. S. 2- (REV. 4-bS) _ Kw~~~~ ~ ~ ~ - ~ ~ . ~7w!~` . ~ - ~ . r ~ • ~~*3: " . ~ . ' C _ i lw~by-c~Mfi? that o~ to Nn iotbM?Ino-na~yd tm~~ M~.~nb oi ~fb~ 634!(q~, • - Intwnai br~rMn Ood~, iwv~ bw+ so~is9d with n~p~t! io th~ taz~s ~vw~ot!d O~low. t~pMhK . witl+ . oq Me~lulory oelditian Prwidd bY S~ction ~3~ 1 t ond Nwt tM IiM~ fot MKh Imws did stotutory ad~ ~ 1~?~'Y ~ P~'~~ in tM oHio~BB ~ ~1otk~ ~1 ' 4 inrernal ~vMw~ fmr ~Mn w~os 61~d o~+ ~ a , 19T, b h~nb~r t ~ ~ ~ ~ ~.a,. ~ ,~b ~ ~ 2a1316 ~ nloas a ,h. to~lowle~p ta~s. . - - ~ . - - NAME OF TAXNI1VBt ~ ~t . RBIDH~ICE OR RAC~ Of NJSII~E56 - ~ ~ f~~ ~ Cl/~S5 O!~ T/1X UNPAi~ WANCE . (Tm~ IOMiwn Eaa~ No.l P~lOD B~~ I\SSE~MBVt QA1E IOfi~lIlFYNr(i t~/MOB OF /~SBSMB~R ~ ar w t~ ta - - i ~IL ~1i~M M~iir~ ~~t~1ii t ~ ~ ~ ~ ~ ~ ~ . ~ i - ? - i S - ; i , , ~ . ~ I - _ M ~ ~ ~ ~ ~ ~ ~ M. ~ri1t ~ roRK s ly~.~ I ~ i s wmvess my t~«~d ~ Jaoksort~t'tto. Ftor~ida , on this, 5 tha.~$tJ1_.~day of Novsnib~r ,19 70 ~ ~ amna a~~dt af ~rs~~ er R+ap~+! . . s S~fe'~ Fl'1D~dY21f~ ~ Jr ~ t , '~6 of efllav auNwrd.d br iow a tdo~ od~nowl.dp~riw. is a+h~ vd~d~N of O~. o.C.M. :b~t GL ~1~ ~~1~~1 ?~?Rr ~--Te b. ~..d M. n~~~p pu~..« . ~ ~ ~ ~ ~ ~~_~~~A., ~ ~