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"STATE of FLORIDA ~
DOCUMfhtTARY STAMP TAX ~tr
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- ~ ~ DEPT. OF REVENUE i`
• ~ ~ - P.. = Rcct~•~e 00.3 0 i
. _ _ DOf ~~lEt? t~ ,~Y
STATE of ~ /4iei c?A ~ ~ n _
GE?I. GEC 21'78 00 0 0. 5 5
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R!. -
COUNTY OF %//IQ~P7~i? ~ - -
Befo/re me, the undersig/ned authority, this day personally appeared
~iCL ~p~AS ~C L/ F to me well kna+n
and known to me to be the individual described in and who executed
the foregoing instrument and she acknowledged before me that I executed
the same for the purpose therein expressed.
{r1ITNESS my hand and official seal this_~day of ash
A.D. 19~
j L Ol,~/r4~c°
j Notary Public in and for the
and State aforesaid '
V Notary Public. State of t=torida at lugs ~ .'~~.~`r 'ti`~b
1JIy Comauss'~s kxpires Nor. 1, 1481 - - - 4~ a "dC'>{ t? s
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BOOK 3~0 PAGE V W
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