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IN WITNk:SS WHEKt:OF, ~ht Muitg~gor has rtecuted iheae prcunts unde: ual the day ~nd ytat firsl ~buve wntten.
S~gnzd, sraltd ~nd delivr~ in 1hr prcsen:t oi: ~ /
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(SEAL)
(Corpotate Name)
Psesid~nt
AttesL
$TATF, OF FLORIDA ~
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•;:~p~~1pp_ ST. LUCIT ~
~'i ! 12, 197~ Allen Quay & Anne D.
~ 'the Toteyoing uutrument was acknowlod~e?d before me this day Jan'
. CQI~x+~_'liis t~rife, Date
~ _
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, ~ ;
~ t. ; = Signature of n Taking Acknuwled6eme t
F~. ~ NOTARY SLIC , STATE OF ~ ORIDA AT
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~ Tide or R~nk Serial Number (if any)
~ ~~ll~•ui~`~1"~ottpot~nnoN ~GE. My coamnission expires : 4/7/78
STATE OF )
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COUNTY OF )
The foregoing instrument was acknow•ledged befure me this d~y ~
Date
by of
Name of U~cer and Title • Name of Corpontion
a un behalf of the Cotporatioa
State or Place of Corporatiun
~ ' ~~'~.'~~~~,E~~~`~~Y.
ROQER IOiT11~S ~~~ure ot Person Takin~t Acknowkdgement
` ~ CIERK CtRCUI? COUA
s c r-^rs; VERIFIF.d itleor Rank Serial IVumber (if any)
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€ ~ O~~ FOR PARTNERSHIP ~AN 13 10 ~a AM ~~8 '']~1?~~
~ ~ ~ y ~ STATE OF ) ,7N
~ ,..T„ ro ~ : S
c ~ ~ QOUNTY OF )
; L; N. The foregoing instrument was acknowledged before me this day -
- - Date
r ~
~ •:s ~ by on behalf of
y ~ Name of Acknowled~qng Partner or Agent `
a -
~ a parinership_
~ Sigwture of Perwn Takir~ Acknowied~ment
k'
Titk or Rinlc Serial Number (if any)
- FOR AN INDIVIDUAL ACTING AS PRINCIPAL BY AN ATTQRNEY IN FACI:
~
` SfATE OF )
~ -s
COUNtY OF )
The foregoing instrument w~as acknow:edged before me this day
Date
" by as Attorney in hct on ~ehal[ of
Name of Attotney In Fact Na~ of Principal
- Signature of Person Taking Actnowkd~ement
- Titk or Ranlc Serial Number (if any)
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BY ANY PUBUC OFFICER, TRUS'fEE OR PERSONAL RFPRESENfAIiVE
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STATE OF )
: s
COUNfY OF )
: The foregoing instiument wu acknowkdged before me this day
Date
_ by
Name and Titlc of Position
~5 Segnature of Person Takin6 Acknowkdgement
:;s ~
Titk or Rtnk Serial Number (if any)
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