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i ~ r I - ~ i ~ ~ - . I E ~ ' - ~ ~ THIS FMIAlKIN6 STATEMENT h P~+~~ 1o e AI'wq ofRw /or ~ V~~~ 1e Nr Urtaw CaaiwMrei~i Codn 3. Mo~wiM ds~ (if a~l): ~ 1. O~b1er(s) (lo~t Naw Fint1 o~d oddrrss(~s1/a~ 7 . S~wr~d Mf(~u1 awd addiw4~s) hr F~ Off~eZOSw• iir. Mr~6w. ~ fi~ O(Bw) CamP, Reysoad & 3bsron Geae~al Finsnae ~orporati.cn i tEO ~MO sEc p~ ~ LIfC1E COIi~ 5?O? K311ni'II9y di?8II1L8 3018 . eder8l High~tqy RO~E~ FOITq~a La. Ft. Pierce, FL 33450 Fti. Pies~ce, FL 33~450 a~ERK ;cwT couRt - ?.FC4RA vFR:F1E0 i rlw: Hwo~cwiy .roN~».~t ao.... ,h. followMo +yn.s tor c+a~s1 « RoP.•yr, - ~ ~ ~ t~/~ ' II is ~ ~ All ef e6• cowwwer ~ods ~ locat~d in or about ~h~ prwiis~s constitutin' th~ d~Lto~s' r~sidw~c~ aR = tl~~ir oJdr~ss obov~ sM f«t6 or o1 af~ o1h~r a~Artst b vhieh th~ sa~~ wer r~~~d md ~ orop~rhr . list~d ?~b.. . 3. l1s~i~yw(s) ef S~aw~d ?~ry vd /Ldd?e~s(~s) ~ Th~ folbwin' proP~ry: ~ 294569 ~ 6. tn~ .o..A osM.Y. .AO.. .Y..b.W ..A.r, Mb.. ,w~s ~M 11~ ..V~.. ~r 0.... ]0~. R.ib ,~.iM.4 N M..... M.. ~~569 ~ da.d o~ M~ wv+aorf ws.w+~ rov~/ ~r~. wd A M O1eo~ m ew/ ~Ilrarl r i~rlr twr~rit ~~r M~~oe~/. ~ . This ffO/fAMM ~f ~~ld wi1~101/f I~M ~/Orf f~plphM~ 10 pM~d O f~W~il~ ~1M~fMt ~II OO40MO1. (U1K~ ~ if 30~ ~k~ady wbNn lo O s~cwil~ inMtq iw anodN~ ~wisdicfion .rhen if rof brovy6t ile Nrs iUat~. wAid is prewds of Mr wioi~sl colisweel dan.~d aAo.~ iw wAid e s~wwity hNe~ff ~ros p.hcW: . Chck ~ i1 cevsndz ~ Irowd~ ef Cellobrel en elso os~d. ~ hadrtfs of GoDaMol an also csrw~d. Iio. ef add'itiawl Sl~ri pr~~d: f;~.e .~:u~: CZ~IC OY C~TCtI~t. COllrti 0 R ~ ~~ae ~orp~ ation J~ ~ dr. V ~f~~~~ /~~2~ SiynoM~ts) ef (sl Siiw~Aw+(s) eF Sw.*ed I~rh(ia+l STAl10ARD FORM - FORM tKC-1 (1) Filirb Officer C~ny - Alphabeticat a~,,,, ~,R,a,, sb,.. 5~4 f+~„d, ~ - -_r - - - - - - ~ ; ~;v*; ~ ~ _ _ _ ~ , _ _