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THtS f1 ING.STtTEAtENT is posoMOd ro o fNing effitor fa filireq pxsuonl a tM Uwifarw Coa+rrrorrJd Cody: S. IAotvriy dote ;if my;: ~ -
Oob/or;s) Bost Novo Fint) and oddrossi.s) 2. Soared Iory(ios) and eddrastos) tw til:y Otti.r to.s.. T~... N..br. crJ fi(+y OH~c..
' RO[~SSIS, I~t1~T3 D. S[N BAi(IIC 9T. ISIS ~INt'Y
FnG;SSIS, QOI~l3T1~N1'II(106 D. - Posh O~fioe Box 8 -
167 Coatis Street Fort Pieroe, Florida 33450 y
Ptat t St. ?~ucie, FL 33452
- t. This finorrt:rg stat.ooM town tM following ypoa for itowrsl of popery: .
As per attad~ed sd~edule A ~ -
S. Ass:grro.(s) d S.arrod ?ortp a•d Addnasiosl
' 6. T)r ac.nd pttlr)..law .pttUr.(c) appoon bslo., rr.Mt r6a du loop r.0.r.d a Cf,~sn 101. Fkrdo S1dWt, I o+r. b+e bs..
ptoc.d a r1.. irowrrors w/r.ww. a.[r.d Arb?. ad .i Ir fbt.d a a.p .ddlo.d otd sr.~lY arrr.o..r +at wo? tr w rc.r.d. ~ _
This stotooiorrf h fihid witharl dN dobter's signotvro b porfM a soarriy int.ro./ in tdbhrd. (Chock ®if ao) ,
f`] Already srrbjoct to o soarriy intarost in owothor jwisdretion when it ww brerrphf into this staN.
fl wt+ich is pecoods e? tlro Miginol tdbNrd doscrilr.d aibsvo iA wtrith a soswitr inNrast wM porfocNd: -
Chock ®if covered: Iroeoods of Coilotord ara dse cewrod. redacts d Cotlalwd an also to~orod. No. of odditiond Shoots presented: -
` Filed with: ~..~~~:a.>ti ~ ~Zt ~lrt sSt. ~@ F'Lorida
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4 ~ C_ AN ST~4 NT . i.l0 S n. ~ v3 ~ ~ i ~T:
S~gnewr^~ d G6toris) n(s) of Socwod ?o.trtio?)
STANDARD FORM -FORM UCC-1 ~~3~~