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HomeMy WebLinkAbout0377 r~ ~ . . . . , ~ , . ~ ~ TWS iWANCit~C' STI~iHNEM h pi~uwNd ~o ~ Gl:y o8'.c~. lw sli+iq pxwoe/ f~o A» Uwifuno Coiuw~rWi Cod~: , . ~ ~ Mowrihr dW~ Id oey} ~ ~ i_ D~81or(~J QoM Nwn~ FhM) a~d oddnss(~s) 2. S~cyr~d Vwf~fNs~ ond eddr~s~(~sl for Fil~np p4cc~. {OoN. Twn~. Numb~~. ond f il~nq OfGc~1- s i:o~l P, =Zose I~; --:ousehold + in•u:~ce ~~orprost' ors ~ED ~0 aECOaoEO ~ ' 19O7 Ave 0 PO _~x ~219 SL~uCt COUMttr F~~ -3 ~ r t Yierce '~'1 33~~0 ~ F'ierce ~'1 ~0 - ROCE~ FOlTRAS ~ - CE f RK C'.RCU1T COUR . _ - ;"~;c~fp : ~ iAb Nwwc~+q sbf«s~.N co.~.s ~M bMo~.twp hV~a (x uaa.sl d o•oo+~?r: ~ ' J~4 20 12 3~ PM'?8 ar~~. ;o:: ~ ti? oL ~ ~u~s 1 se~L~o~pi sors 4U'74~5 1 ~olor '.~'V, 2:i~n~:i:z:- ~u~le, ~ s ~ove-r~i~i ~~e, I rei ri~;, ?:JOOQfP:.`'eY_eds, i C:'~`_'~t L%fC~~ 5 dressers, 1 W3S;lEI' S. ~u~p~«{sldS~arr~dierhrend~.ddr~ssl~il • ~ ~ 0. CA~d 1( a~~ ? TiH s~awps rpo~rN 6i C1~ope~-201. f.S. ba.~ NM visc~ ow ~M nrawluw~ wer~m~n~s s~cu.~d ~ A~r~. ew1.'~p b~ pbc~1 ow m~ ed~iriowei oM siw~:iei rusrrMw~wt rwt w.er w s~cvr~d. ~ N 111s f1NMMt b fN~d ~~MoW d~6fer't spwoWr~ b~r(W e s~a~~ MNr~st M toRN~ra1. ICA~c? QQ d w) - ? Ab~od1 wb~M b~ fKVri1~ InNr~f/ M~tr "ryNSlicNp~ ~AM M~~ ?rory?H M4 ~bb sMN_ • ~ ~ ?.A1d N procNd~ d~~ aq+eal calloNrd d~wW~d ale.~ t+ ~Aid e s~crrllt w~r~y ws a~ct~d: . - CMd ~ M co.~rd: Q o~«~~ds d CoueNrd o~~ e!w w.M~A. ? Prod.ios d CoOa~~d or~ olw co.~r~d. No. d odd~nonol SANrs p.n~n~~d Fil~d ~rith: . ~ ~ ~ d~~. B K.~ S 9 P9 .3~1 0.~~. ~ I ~ ' ~ sy:" ~ [1/1~! ~Yl - \ \ gy, (J`/~ SpwMu~~( d D~?4.ta1 noMr~is) d S~cvr~d Po.t~~MSI ~ . . . _ - . . . , ~b.ti~~ STANDARD FORM - FORM U~C-1 . ~W~F~/?1~~AM5. ~r,re~; . ' . _ . =1 : _ ra 2..°-~`'~'~."?_'.~'.s'+ ~x``r~ ~ - - - . . - a" ~y: . . _ . _ ' - - :~~y,.,~~w~~; - _ 3~-• _ ~ . . . - . . -