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IN i1TNESS ~NEREOF, the sa~d moctgagcx has hereunto set his hend and seal the day ard year first afo~e- ?
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Si sealed. and delivered '~he presence ot- ' - ,
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STATE OF FI.aRIDA
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COUNTY OF FLa2IW, • a single adult
unremarried aida~,
Befoce me pesunally appeared DiAISY G71RS~iSLL. a~i / and E,DIIi1Rp C~1RSW6IS.. her son./.
itiipc~ to tae weU knu~vn aad knaovn to me to be the i~ividuels described lA Yl1~ ~i}l0 CXECIIiEd tb!? fatCgOlpg
instiwaeat~~~ ackao~ledged befoce me Wat they executed the same fa the pucposes tlserein espc~ssed. !
~~-~'l~FSS~yJ~and aad official seal this 13th aeY ~ ' • 19 ~l~ ~
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L~' c. i Not Pu Itc in and ~or l e cowatr State aJoresaid
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G~ . lb~q Pu~k. 5~ e~ Flaid~ ~t l~
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. - ' Yy commission expires Y~? Com~ssion E~ra S~. l. ~~7~
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STA'rE• OP"`''~
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COUNTY OF _
HeEoce me persa?ally appea:ed . to me ~vell knavn and k.~own to me to
be the individual described ia and who e:ecuted the foregoing instrument. and acknonvledged befo~e me that he ~
executed the same for the pnrposes t6erein expcessed.
AITNESS my hand aad official seal this ~ day of . 19
~ 21.2963 ~ ~ _ .
i1lE~ ANO REC~ROEO Notary Pu6lic in ond ~or ~he county and State a foresaid
ST.IUCtE COUM r RA. ;
NOGER POtTIUt ~yy canmission e:pires
CLERR CtitCWt C0111lT
REC4R0 YERiF1E0e~..~.
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Thia ro~ is Baed ie connection
.rit6 aart6aaea inaored ooder t6e
onr to (oar~ta~ilr pro~isioas of
t6e Natioesl Hoa~in Act. ~
g - • . U. S_ GOYERMMENf P1tIMIN(' OFFKE If70 O-~C"1-71T .
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