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0437
. . ~ . . , , , • . ~i ; II f THIS FlNANCIPI('s STAiEMB~(f is pie~eM~d b o filinp offio~r for fili+o pwaua~r b the Unilaw~ Cann~rod C~od~: 3. Mohrrifp dott (if anp:) ~ OebMrls) M~t Nan~ Fint] ad addwsslM) ~~!~~r{j~ ~~al~{as~ Far Filinp Offiar ~Oote. Tinr. Nui~a. ~ ' ~ - , A z i~ ad Flinp Offia~) p ` s~..~ ~t,N, s- :~~~v _ ~ ~~e Ci+r• , . - • : ~ ' il T, T~ ti~~•~ iJ~.~~~4~~ Pi.~c., ~la. 33450 • , . . . , , . : ° ,;.z,~ . ~ fl++is Bnanc'+q ~o~M aor.r: Nr folforig t~ps (o. A.n~.) ~ v~op+~h: ~ i ~ ~ ~ . S. /4si~ cf S~cuss.i Party and Add~ssits! ~ ~ r" j, j..,,''..4 ~ ~ . , ~ - ~ ~ ; 6. TM ~eax~d portytsl, wf~wt s~pn~ls) ~s bdow. sta~u lhot the slamps r~quiwd bf~ Chopl~r TO~. , - + T~r: ~)~;l, ~ T S-; t~~.,• ~ Flwido 51oMes, if anr. Iw~re bw~ ploc+~d m N~e pnaniatory iiWW~urwnts swM~d henbp, ond w~l be : ~ • ~ P+o«a on oabtia~ai one .:nila. in.+n.~n:.,or ~a,, s.'o...a.a. I:::.:;CI~, I"..._:,.,":!~1. 334 ~ This stot«naeM is fild witF~out die d~bbr's sipnoww b pwhct a Mairi~r irwwst in c,oNorc~vl. IC1»ck ~ if scl ~ ? ? Alreody t~ibjM b a»awitr int~st in awMnr iurisdictian rlyn iR wot ba?pht i~o lhis sfoN. 3 ? Whid? is prowds of M+a aginol oolla~s?al describd ak+w~ in whid~ o seaKih iraerrst w~ns p~rfecMd: ~ ~ CMck ~ if covet~d: ? Praeds of CoMok~ol or~ oho carend ? hodutb of Colla~ol we oho ao~ed. No. of /ldditiawl SI+eNS prtseot~d: ~ ~ F'iMd witl?: ~ ~ ~ i , a~ • . ah : ~ s~.~sl ef o.l~.W _ ; ; STANDARD fORM - l1CC-1 ; ~ ~ llppwed M R'itl~ood tOickl Swn~. S~cr~wry of Stua. Sfote of ffa.ida { ~ r.-~ ~ - a ~,.A~PHABEfICAL wfws No. ~a~v _ _ . _ ~ ; x~~ ~ < -