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t i i z • ' - ' i ~ ~:VANII'tG S(ATEMfNT ~s p.~s~nt~d ro o id~..q oihc~. Fw f i.nq p~..sronf fo rM ~n~loem Con.nwruo! Cod~. _ -i Mo~~t.t~ do~e ~f ew? . 4 s - ~ - - - - - ~ - - - _ . . . . . - -T ~ - - . . - _ . _ - - - - ~r~ f~~ - - - ri, ~-o.f-~: ~ i ~'~.~.+a • los• flome f..~t w~d odd.ei..... 1 ) t~....w ~ ~r.....: ....J ..w.L~tf i "af'~ t^`~ ~ ' j~'rovi~er,t 'r'ir.a^ce Co^~~~ny i S~. IE ~ ~U~S1S~ uQ,^.@V1P.~le , _ " i ~ , ~ ~-i ~ F~CFS~L! Aver.~le ~ /C~ ~r-~r,.;e i~vPrue I Qt~ww CI~y v ~ Fort Pierce 'r'lori~a i ~~~p~YtQlf1t0 ~ b ;~~~1 ~ar~iens ! ' ! '4 ~ - 3Art , F1-~ ri ~a ' ~ ~ ~ ~ ~ SS ~t `11 ~ - - - ---1--------- i • i,~onuny •rat~mM~ <o.~.~ 1~t loilor~~ ~~pes or dems of MaP~•~r , i ~ ~ Ir A!i of rh~ ~w~n~hold poa3+ ~+~!r N~rt~F4r k+ta~eQ N~!el+~ar'4 'lt+de!![! ~!^~x Nt iorih ~bov~. ~ - - '?t~'~M D~Opt~h dtKnb~d ri ; S Ass.qn~~ ~ ei $~cu~~1 ~arft awd Addrt+f~~~f ~ j - iit~ew) . . t ~ . . j : .v . . _ . . . _ . . . - ~ nec~ .t r.v~ ;~1ne .ro.-9+ +*a-••r_~ b~ C~ac'sr 2~!. f S ~o.• beeo~ V~oc~d on Me pran~~~w~ ~ns~.um~h secwed ' . j ~~.ebf. ond r~H M ptoce~ on o.•~ odd~~~rwl and s~m~iw ~natrument ehor ~*ror b+ ~o s~cu~~d. t 'i . - - . _ . _ . . _ . _ - . _ . . - - . - ~ _ swt~w~e.w n ~,I~d ~.rn„n rM d•e~o. ~.•y.wrv~• ro p~.i«~ o se.~nt~ :oe~r~s~ ~n coflo~~rol Checl ~ ii w :_i;r_a ~ e:acv~.fy .ne~~es+ •rt a~o~M. ~vr~sd4e~on v.Mw ~~t ~.oa Erovqbt ~n~e M;f seaN. - .~A.~A p~w.~6s of r!v o..~~~ol co~to~e.ol d~~c..b~d vbon .r ~h.c# e ~ec~~a~ ~~i~.~s1 .~m P«~~cHd. - - ~ - - - . . . - - - aowe.~d ~?•oc~ed+ o+ Cotio*e.ol o.~ also co.~r~d ?rod~xn o/ Cotlo~~~pl ~r~ oiw cows~d. No. of eAd.t~onol SMe~~ prtf~.N~d. . F.'ed «,~1~ ~t. : .3^:@ LCS?1I1t,'1 ~+OllTtl'iOiISQ ' _ ~ :a - - _ r Vi id~a :n~~nacxi c ~0~~ `~l = •V , - . ~ ~e.>e ~rovi :ier_L r'ir.a^ce +:or:aany ~ - / ~~-C1- ~ s` a~ ~r ~ = bp.w*v,e S:q~»w... d ?w~~ ws: `~i = s = STANDARD fORM - FORM UCC-1 ~ !1 j F~i~~,q Off'iar Copy - I!!p~sb~tiul = Appro~~d b~ Tow Adww~. S~cr~wry of 5•c~~. S~o~s o~ ~'c !30 , : - - - .~.'7, _ ~ _ ~ . . , . . _ . . . . . . . . . _ -