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l ;~'799~:4 ~ IN RE: Lots 9, 10 and 11, Block 25, Unit 5 and Lots 8, 9 and 10, Block 23, Unit 6, Indian River Estates, as per plat thereof on file in Pla t Book 10 at Pages 57 and 58 of the public records of St. Lucie County, Florida. . . i :;r_t;l?1~J STATE OF ILUNOIS ~ . ;<<`` u : : ~ - } << ~ ~ - ~ iJ~r; `,^ti~ s - MGOlCAL CERTiFICATE OF OEA7N ' ~ ~ ~ _ = _ _ - b. 1 s~ ~ ~ <f rr ' ~ ~ t~•CE rF [.E~1~~ - - ~ - - _ - ~ _ ( ~ ~ . . ~ c i~e S'.\fE ? ( CCUhT~ ? i, lr.~l kfS~Cf~:Ci . r. o . . . . F- tn ~ IlUNO1S . i-w F c U ~Tr = L : - -~v~_h------ - - -.~.~l~:nu~_ ~ -C~~ ~ ~ ~ c irySiDE c: ..~r ;,m.~ u c., V' i_, ti; - ~ y ef . X ~1`~ e s age. a e o+u•ed To.n c. 'x' :NSiDE .w~x;•o•e ' m~i ~•c m G,ey~, Y. ;o9e. er c,., c ec ~ C3 Ll.l i • ~ij a ~ c~, ' a~~,r~+. _ _ • [_luccro Ci SiA ' LY ' ~ o~ - ~,d. OUT$ JE .o•poo~s ~.~~h o~d ;n c tfr~~'N d. ~ OUulDE G~OfO~t ..m.1; V.d---- ~ ycg~~iy~E ,_j r 7c.r.~A:~ rare . . . ih 1o.~a~~p ro„e nT:./~ 7y ~ i S ~ ~ ~ ~ Rocd ~~~h;c~ No. ~ LU!,',~ Ru.nd D,.t..ct No. , . ,T( :JP11/~_ ' ~ - ~r~ ~ NAME OF HOSDIiA~ OR INST~TUi~QtJ q itrr_ ~A~pF Srw ;-gF5i0ENCE ~DC~ESS ~ S••.~r 4 Nc o. ? f a c~c ?o s, C~+:c~) ~ L ~ • ' ~ IN f` . ~s~ _ - " ~ ° ~ l"aa~'e~_;''e~v~u.al /roe~i.t~C ~l~a~e- - , ~ y yv Y~ F. If nor .n ~osp fe~ w.n:r r„f.cn. q.e S~:ec 6 No o~ R F 0. an:i Dc~+ CH~te ~1~ /~~slf~ l• ~ . ' ' ~ 'd ' - ~ _L_ al~'~Y•~.^~ee-- 4 ~ - a.~rr 7- L`~d dece~en~ .es~•'e C~+ A fAtN~ rES f~ k^v ~ - _ _ : ~ ~ ~ ' 1 NAME ~F e. ~c~~ST~ b ;M~DDtEI - ~l. ~ ~ c. t~~sr~ a. D~TE OF I4ONTM: -~.~v: t•t,•R D.CE~SED •'C1, DEnTN = ` ~ cclia _ _ hrR Fiiadercuoft 30, 1963 ; ••"'•=•~-L c S'•X b~/~~_~ ••.•^Q!c.~. V v"R M/~RRtED a DnTE OF BIRTH v nGE I,n~e~.~ / 1 E t ,.-ee. ~ ee. N tis. l ~T~ 1. ~ '1 : 1' j` ~ ~ / 'b':~~QWFJ~~ -,~~~!`a ~ ,t ? .aw.r. o. .~~v., i.i ~ ~ !U' ~'YLLC f .7J~ ~Q/1/u.~~J (scec~l~ / 1 ~ , ~ dOrl ; ~v 3 2~ ,,;~-;:s:,~: occuPn:;cv - e ~us~HESSOR; - s•_ 7i - - - l--l.,- . ~ v ~ , _ ~ ~~o ~it: OF, hDUSTRY ~i. 6iRiNVLI~CE (C~r~ c-~d ~!o'ec~ ~cz,vnco„~~.yj ~7. C,•,xrcr.~o• > _ Cc7 = ~ _ =cJ. , ~ _ _ _ ~ !:l.'Utr~gur:~e - ~~°i'-~e - - 5'°~'-u,a~ 9.1~~~e ff :s. ~ : ~ : ~~3. F~~F+ER fJil ts. MOTHER'S FULI _ ' ~ - - •.nr~IE t~ ~ 1} _~I~O/U! % • /,~"Z/ MAIDEN NAME ~l , . , ^ z , - - - o~ - - --~-Ll'.~6P.~~L /iQ/1/t ~ ;'S :Yos e-:ecs.•~ r.e~ U 5 A.-ea ro•c.~. ~6 SOGIAL SECUQITY 17_ INiORi~1ANT i - _ ~c: L:~~ res. -e. o. ?~ro~~) 'G..e.o, o, oo•n c/ .r-.:e1 NU!dBER e. 516NATURE ~~e L~vune f - J ~ I ` t_1 .----C ~ ~ p ~ ~ _ ` n O ~ ~ ~ _ /~O- - =-==w-_=---- b. D~~j SS ~-~_L A- c REU'~p!~5l~QI~Z~~J~ c--~~?e/lL7' S ~~~CUfl~ 7N~1/.L6~ ~ECEhSFR ~(SIcQ c~` ~ ie ~aED!C~~ C~USE OF ~E~.TH ~ ~d / U4~J.-_n~QV ~ = ` _ v. ~ - ~ eART ~ LfATH WAS~~A7.ED dr. ~f.~e, or~. o-e co~,e u~ r.~e ~u IA1 IS) an0 (Cl. - ~ 1 ~ ~ ` o ~ i ~ ~r.~uED~A1f GUSE (A) ~NTEtvrl {{iwEiN _ y ~ r` Y~ ~ vSSj r~0 OF~iN _ _ _ ; . . . . . _ . . . .Cmtci/rvnu. o~ ~e~ou,~~t . . . . . . _ . . . . . . . _ . . . . . . . . . . . . _ . ~f . oa . , ~ ; _ ~ ~ i Co,e,r:on:. r~ w+.. ~ _ - ~ ~ - M y~.~.;:~,o ~ r'~ c i• +•e cLc~e IMMED~ATE r.. . .....1/ C ~~ll~ Q~ ..C . 2 •i_R~ ~ ? ` - _ - ~ i.~:.SE 1~1 S'~'~~~ L Q/L U~R { ~ ~ ! t~t :i~.CERIYlNG C_e •c IC! ~ . _ ~ i ce~se iesi. ~ _ Z 2=:1 n ~;b~lT n. G'rFR ScGN~iIGA4i ~G'~C~T~CNS CGNT~~~U1i?4~ 70 Dfn?N !Ui NOt ~EIniED t0 TNi TF~NINAi CO~:D~7tON 0 AUTC~SY7 Q1 } y Gt:EN IN ?A~T 1(Aj ~n 3 ~ ~ : ; i. v ~ - ~ ~ r ~ ~ ' I `ORQ • W t0~ Owtt oI oI[~~noM. n~wr 9b ~/•~,o. •,.e.rc~ or o.u~~.w ~ ~ . - m r ~ 1~7Z. ~Q! 11D~.~LQILC.ZJZLJ!•'LL O rE5 Q t+C ~ ~ ~ \ n r ' + i ~ i NOTE: IF ~n ~njury .+~s ~nvobed ~n this de~4h, fhe Ccronar musi b~ nofiiied. ~ - ` r = - p~ - 2-- --6~- - - ~ 6.3 ?L ! Fe.e/tJj certd~ ik~i f o'rerdrd dcteosed 4pn j ~q - . r° • 19 ~he~ Ilod to« ~F.e deceoced o4re ` on /1~O ~/_IS ~ ~ _-S 2 ! 19 - . ond droM acwred o~---~ M_ !ra* rhF co~~es wd on rhe dae ir~ed abo.e. - :t _ _ _ ji S:g~a~..,.,~...~ORR ~/LOLL~j ~~['i.... ....._.........M.D. L;~. Nc. ~:GV~~. . Ca!e 5/~~63-... ` ~ f `q~ ~,t R ' Ir Add•ess . W ~3 /~D'J4E'.V~l.~ /~iOQ(~j [X'lttL~ ?~.C.d . Pkor.e . ~ ; ' - - - - - ' - - -~:1 c; S=OS • o,,P.:~i Yv~L~CJCJGYJC%:.YJCXXX: S/~/!~3 ~~23. F:;N~R,~L DtAEC!CSt L~~ " ' ~ ~ _ ~ C_~a-1ER~ ~i!=~'~E~ft O~ %~~OCIVQL 1 ~ ,-~:.~'i,cE ? ~UlilL 7. SLG~VCJL . . . . r: ~ . ~ - _ r ^ • ! _ . . - r . . 1~.i,~:l~si.rlG 9.Cl,i~w :1 F = ~C~J'3-~.~ t.c.cc~o _ : . , ~ . .c~ ~ ~ii~~v J/,/.irc,~t,~ _ . - - ' _ ~ i - ) . . l~~.v ~ - , . _ _ , 7 1/3 - / . _ _ ! ' _ - - - - ' J ,--l;v l: : r, :~f~• ~r i! ~ _ ~'?2 ~ 2'799~ ~ _ j il~ QYc C Y ~~Z ~i ~ V~~ t AE~ Aa ~f5q`~1~ ~.~ww. r c ~ - ~ 0~ ~ ~ ~ = LAW OFFICES - WILLES, BITTAN 8~ WILLES 3 P. O. BOX 909 FORT PIERGE. FLORIDA ~~4d0 pOOX 226 P~cf ~.;s -'.•-a > - - - - . . ~ . . . _ 5 . .