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STAT$ OF FLORIDA -
COUNTY OF ST. LUCIS
We, JOANNA H. CUSHWA, C~~xXJ~ ZZL- _ aad
, the teatator and the
Witnesaes respectivelg, whose names are siqned to the foreqoing
instruaaent, beinq first duly sworn, do hereby declare to the un~ler-
siqned officer-that the testator signed the instrument as her Last
Will and that she siqned voluntarily and that each of the witnesses
in the presence of each other signed the Will as a witness and that -
to the best of the knowledge of each witness the testator v~as at .
the time 18 or more yeare of age, of sound mind and under no
conatraint or undue-influence. .
T'~+ '
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W tnesB -
" W tness
Subscribed and acknowledqed before me by JOANNA H. CUSHWA, the
testator, and subscribed and sworn-to before me by
Q ~ ~ and , the
~
~vitneseea, on thia the /9~'' day of ~ ,A.D.
. 1975. ~
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Nota c
- " ~ State of Florida at ~
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' My comzaission expires
' ~~r. r . ~ ~ • V ~ ' 7 ~ 7 7 .
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