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IN ~ITHESS ~HEREOF, the said mortgagor hes herou~tq tt his hortd al the dey end year first afore-
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ned, sea , a d delivefed in the pcesence ot-
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STATE OF FLORIDA
COUNTY OF 3t. Iucie ss:
Before me pe:sonally appeared gtQlee ~p~ end yn~i~ ~•p,MD
his wife. to me well known and known to me to be the individuals dcscribed in ead w1~o executed the faegoing
iastrwaent, aad ackaowledged before me that they executed the same fa the purpases tberein expceased.
ATPH~SS a~y haad and official seal this dpy oE , 19~
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f} Notary P lic iR and /ar the county d State a/oresaid
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: ; cs = Yy commiasioa expir~ ~pril 16~ 1973
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Before me pecsonally oppeared . to me well knawn and known to me to
be the individual described in end who executed the foregoing instrunient. aed acknarvledged befae me that he
executed the same for the purposes therein expcrssed.
~ITNESS my hand and officiel seal this day of . 19
Notary Pu61ic in and for the county and Stote ajoresaid
My commissioe expires
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; filE01?MO RECOlt9E~
i iT. ~UCIE COUMT~1 f~ •
! Il06ER POITIIAs ~
E C~E1tK CIRCUtt COtMt
; RECOaO YER~FIEO
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: ~ 30 11 ws I~'11
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~ This (orm mar be used aa the securitg~
~ ina~romeat ie connection with mortgages
~ to be insured under Sections 203 and 222. .
~ and in coanection wit6 "individual mon-
~ gages" to be insured under Sections 213,
~ 220, 221, 233, 809 and 810 0! the Natioo-
~
al Housia~t Act.
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