Loading...
HomeMy WebLinkAbout0810 / . ~ ~ 39z417 ~ CERTI~IEQ G PY 1 NEftC[iY CERTIFY THE: GOPY REPRODUGCL) 6CLOW Tn ~E A Tht'F APtU CORF[:C: ~-f1F'Y r•F ' YNC OF~iGItHA:_ FiECORO Ot~ FILE iN TNE 6URCAU UF ViTAL STA1'!'i ~ICS OF THF' :-1A i f . t-~ORIUA, DEPARTMENT UF NCAI.I"H APiU REHABlL!TAT\'E SCRYICES. RT JACKSC~NV~LL'=. FLQRtGA. ~A07 ~iRLfD UNLC£S ~HC SC~I. OF 1ML~ STATC OF TLCUI~UA. OFP~FiMENT C1~ I+tALTH 4~..'~ RF~~~•f:~L~~=~'`~~ tcfRYlCIS IS AiflXCO.~ A . 1 / !i_~r,- t'~~l~~r r' . ~``a / _ ) '~/1 . ~'lNti.L: i i!'~ _ ~va.u. / ~ La.i1V~.+r !••`,"1 t1AT[ w~4~C7A/1R 104 Ylf~l f11~T15'~C`. . , - . C_ • . ~ .r~ [xrwwTri~~ os M(~UN r~..~o~~-~r.e~v~ ~ ' Nwv~ccs ~ ' _ . _ - _ ......~1~"'. ` c • - - - ' -G~73t2 4~R'Fl~~l.t;rA'1'~ ~F DtATH ' 7~ ~~nwetil ol I~vlt~ ~w.j ~~Lw{dlit.ti~r `~r.i.n v. . ~ ~ O ~ I D A RTATE i1LE KO.'---. ' - - - - !N\M~ ~M IM ~11~1 . ~cc~s~w..a s ro jl~i DtC!~.tD--w~Mt ~ ~a:••~ ,.a~ ;Cwtt Ot U:wiM - - , ~ ~ i - ~ r=~~ ? _~~`f~.s I~ ,_1_~ 7~_• - - c~CE ...•-~...:w. ..a...., T~Gt. ...f. u.,~. ~ n•. ._an e c..-TC~lt ~ 6iR'H .~.r- s.., :CUl,tit~ Ot Ot~tN ttC .1rtCY1 ~ •~~~rL.• .~l~~t• bS N~f ro~f ti'~ ~ 1 r ~ r_' _ ' - - c~: ~S~ j1 1p ~V~ ~ - r.5i1 ~ 1• CtT1t, tOw?~ OR 1pC~•.fN~ (if 6fwln ~ ^ s~w c~n •...n MOyhiwl OR OIMf~ HS1QUlY`N--fi4vj .r_• ~.•.n, ..•n ..:e• .-o . n• v~cu. .if o~ .w i 1_ o j, .-i~ - . U-• ' _ .1~ ~ ~~~r~ .~i..rc:r Z'c~;__ u _~0_~ - - _ SiAff (1~ ~R:?~ . r ra+ ~ s• .+.~~TtIT~i1.4 'vf wM~i COlM7P~ w~ltlED. NEYEt ru~i.[ D. ~ ~SUl~'+vNG S~J:~S[ c,.~ -.•e~ti ~ co...+..~ vreoqweo.a+voaeEa wc.•, ~ - ~ -=z r! ? • i.i . :i . =i . M l<10' ~i4 - - _ ~_i.---- - - - - ~OCUi SiGU[+: v NJMliR ' JSJRI OCCV?AT16N ~4M a~+0 p.wa w.~ ca..•. .c+~ c~ cr:0 O? k:S*+ESS ~ ~r:.uSr~r wM~w~G IW(. n~r O KT~l01 " Unknoti•m 1~ \i~' r. ~ C.: ~C7~.!:~~' i:7~ T"~,'j~. ' ; ~1~~'•~.~+ ' ' _ _ _-._'_y'w ___~'.T__ _ . ~:SiDf~KF-S%~if COtMiiY C:f,lOwM. W IOCATI('iN 1:~+cn ~r.n STREET~a?+D NtW?tf . srKM~ .~s W r0 ,aT~'~,f~•-• -i++r•i n ~to -'n,,~- .~.n ~w v~ i~.% •r~•~ ~ - . . . _ i~l1~f -NAM~ svSl r?b-~ \~i~ M~TM~~-Vlfy(M VAA~ r~~Y~ ~.:.I :~i' ~S il. j~ • 1~ (7' " l ; 1lI~MIMf1-~eUVF ••MJIRQK' AOGRESS ~sw~n oe ~ r~. •.o . tm u~~..•, s~.», t~r~ j th - - - !1G,~:~l 17? >!>r :1 ~ ? •~!1 • -T-~ j.~l _ -ql -~'l " aw. ~ nu p;. rel ~~o k?1 N1'~'~~w Ow~It ~wL N~fw ~ ~ pEwlq wwi GUSEO tY. ~EMl~ Owtl O?4 C~uSE ~ti t~ F~R ' ~ ~ wrLLtYlfC~Ytf ' ~ c'RRDiH G tiRRES T _ f sor~-~~.K: - t co»~.no..s. ~ NE/~'+ ORRN96 TR~vn~N ri c ~/yrif~ ? ~«t~ ~.~r •.u sd (N ~r~N~If C~wt~ tsf. «r! W.O~ ~f ~ t.7~sfOU~Kt O,: ~ - •~~t~w4 f~~ Vi~~f- ~ ~1MG C~Yi! \~it SG ?E~~L ~ ~Y ~ <<~ TRAIJMAT/ [ fl/y~1/rAT/CN ,~E~"T ~ EG F ~~,?c rc~~L riuli OfNE! S~GNM~CAN7 CptpTK)NS- ew~~o.~ ea.~uww ~o wa. ws .w nrur~ w c..n~ ew~.. ..n ..e~ wVTO1S~ rt 1tEf ~ar. •..awos ca.- ~MS M w0. YNUO w MM~.awr4 41rM s~ NBaC'M/IY'N ~?~Sc~,=~'NL /~ENic/~',plf6'E - E"~'r T~~~ .~~:r'rAi?i+f Nr:p~ /i~ i fR ~•tr a~ ' :s ~ -iJ?'~"E~T'3iaL~~LI . 1 rOAM. i~t. `Hf i R • Kpw Me ! OCCi1R~tD • we~ ...+w~ o+ ..~wr~. •r ~.sr . w ~u~ ¦ ar. ~ ~ ul~f~~ ~ ~ G ~ ~ 2 - 76 ~ / 2 U ~ ~ ~ ~ .ys ~'Aa ~eyr !N .-a.~= ~ivE wYi1R~ A! t M1MI~1f ~a+. ~r+~. w~[ef. wc~ar~. IOCAi~ON . s~o M~.r w. eu~ fe ~o+~. tr.w ~ ~ ~~wcinwaw~w~ ws..~~t ~~cr?~ ~ f'i0E O iCErEPEK /Q ~r ~%~iL~~f= - pr tlt ~L f . t y pRbq~wT~QN- .w,~+ w .w .o«~ ~w r uw w .~I.w .un ew . »iw «w ..n. +r eswn~ ot.'w~s .K n..r.. o. rt ~O~r M~ ~W ~OM ?~M ~Y~r i~py~ ~ s ~ Y'!. Y~t. ~O ~.f HS~ n~~~A~~ ~M ~ W~lf s~O~~fOf.f. i~l[ ~ KC4N1 MO~ _~1! 7k 7!~ ~ IM M f0 a! ~~YY6~ 1~.Ma. MKAf1af~OK~ E7AMIMF~ Ot CORO~~E~ OM M MfH W'M .oM a M.w~ na wceM.n v.s «oMO~n.<?e w.• ,a .'~WWM~~ M M~1 ~00~ .ra~w wr .wts+w••or..r ~ O~~O~. t v ~ wOiAM M• ~f~1 ~O.N ' ~ ~ y~w~ oy+f MNIrx 1~ ~p M C~Mbt1 t~~w J ~ „e ~ }h ~ 11~G_fY~`~_/~~L/7~^_'._~rr'Q~...Ll~~ ~~~~~____Z _ _ . __"_b! ~ ~ ":CNI~hE MM'F :nti o~ ~r.n SYGN1lURf r~..u a • • ~ . 6~iE S~C.NF.?-.••cr.s .t.~~ ~ - _H R C ~1 r,, IjV l._:• v r't /".t . t~-~ n? ~ -t 1.. 4. - :c ~ - 7!• ~ - - '~s~-'-- .r ~ ~ , J~G iCO~tSS- ~~?t:r~t• ~ s~ui• c. ~.s »c r-Fr. o•... ; ~ ~ r.. ~ ~T- ~~!r~= ~i~ l:~~~,~.~...~~~- ~~c5~!~~~ r~~ : ~~,<< r f~.~ ',rs ~ _ ; _OCAi~.;-r~ c.•• K.~. l s•.v i ~ ~ •.•.y...Ew?1.G~. ?[.•V~a: i-~Cfr_:r:rGaGtfw~sJCr-rr.µt ~ , ~ :w~. -:~~'~~i :~r`l~.n ~ia('..~~'-'~.~' :~a 'n'•-F- 'v~ i:^.--~ -----ll U- - r _ CAT' ' ~ ~"r__ ' " _ ~ ~ _ r.. ' 'E~nlGal ~Ovt •.aM ehL ~J, ..Sf~ ~ fnn• m ~ • o .c . c.,. o~ _ , s'-•e, f.• ~ . - - - _ : ~ , - . s O T•,; j1" L_r ~ _ ~ ~ _t;t•_syf~~ ~r : 7 i:~ . ~i=' , ~ ~ . •j(l 3 ~yy(~Mf~iG~-ti.r . - -it'Srv.a.- . .ti•-. . . . o.•t r f• yC~. af... ~ ~ ~ .'s ~i - ! / . . l; ~ G._ _i~- . . . ~ / ( 7t: ~-2~- i b ' . ~ ..,,~y _ _ _ _ _ ' i ~ ti ' ~ :s , ~ fILEO ANO REGOROE~ ft.lUCtE COWITY FU. ~ aOCER PO~TR~S 3=~ CLERlc CIRCWT COURT ~ ~X ' . ~?r ~r^IFIfD..~--- ~ ~ fEe t 9 Za ~H'~R ~3 BORK281 PacE 8~g ; ~ $ w~ _ - - - _ _ r~