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_ ' - . \ , . ~ ~ . j . . ~ . { - _ _ _ rH15 flNANCn~1G srwtEMerr a p...M.a a o t~g o~rw to. ~^Y w~~ ~01M unitoew~ GoaNwrdol Codh 3. Mahwitp doN (if an~?~I 2~1 ~ 1. O~b~o~s) U~t Monw P+sf1 and add~sN~) 4. Su~wd lbrhl~s) and a~dr~s~ fw Filinp O(fiou (Oo1~. Ti~ne, Nhm~brr, ~ UiFraac•aco, Linda p CG soX 3i6s~ ~ ~ ~ 706 s. 17tn, st. , Ft. Pierca, Fla. ?3~t>~ FT.SPIER FLORID~A~3 450 ~ ~ ; ~ ~ ~ ~ 358264 , ~ Aa listed on sahedule pA• security liat dated 2-17-T7 S ~..ia ~ s.~,~.d ~n~, ~a ~ ~ ; 6. ih~ s~a~rd PaMsl. wla» si~w~urMs) aPV~s bdow, doNS Mwt Mr s~ips n9uiwd bp CJwp~r 201, florido 51oaAn, if anp. 1~ brw~ pbad an Ny P~1I ie~q~s srw~~d Mnbj~, and will b~ pload on oe~r odtiiiawi and tinriar i~ Mw~ a~s~? b~ os wawd. This stot~N 3a Rid wiA~o~R iM ibN?'s aiprw~w~ b/wbo a a~aRYl? MM~wsr in coYa~laiol. ~Cf~ ~ ii so~ ? Nnodf? wb1~d b a~w+ih? inl~wst in aaAw ~wi~iction rlyn i wos 6ioxglr inb Nws po~e. Q Whid~ is powdt d ~hs ai~inol mNal~ral d~scrib~d abwe i~ wl~ o s~nwi~ inl~st wos p~nc~l~ ~ C~sck ~ if aoreeed: Q hoc~r~ds d CoMatan! or~ olso aw+r~d. 'J Ieoducfs of CoYat«of o~ ofio oe~r+r~J. Ho. of Add'Aioewl SfwMS pwswM~d: ~ ~ FiMd wid~, ~ ~ • ~ ~ ~ . ~ ` INAi~i CO ~ ~ M i ~ SiYnahwN~ N D.6wr1s) d yow,~d 1b~~;ea~ " i . STANDARO FORM FORM -1 • l :(1~ Fil'i~9 Off'rut Co,py - Alpha~titsE d„ e~a ta~ s.e.,. s.Q.e.,, d s.s.. s.~. ..s s~.,.~..