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FORM 185 • NOTARY FOR PROOF OF YVILL
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!t'r. JOHN F . B . CLARK _ _ _
RWFRT JASEN SMITH • Itrtc! ARLENF W. BROOKS
the• 1e•stutc,r ltc•stutri.~1 uncl the 11•itnessc•s respe•c•til•elr. ?1•/tnsc• names ure signed tr, tJte
utluched ur Jc,rrs;c?ins,~ i?t.ctrutnent, he•ittk Jirsl duly slrr,rtr, di? ltereht• declare lu the
undersig?red c~IJice'r shut thr tc~ctrtn,r /tc~ctutrdxl siQuecl t/rr i?tstrnnrent us his (lterl
lust u•il! uttc! thut he• /steel si~nec/ rc,lttnturilr lur dirertecl unnNter tc, .cult fc,r hint (lter).
uttel clie! sn ru/unturill•) uncl Ntul ouch „j the ?1•itne.csec in the presence c?J~ the testutnr
(testutrixl. ul ltis /hrrl rcc/tu•st, and in Nre prrsenre c?J~ e~uc•h utltrr signed the ?vill us u
?ritnc~cs uncl shut h? tltc hc~ct c,J Ihc• kncnl•leclKe +,J euc•h lritness the te•stuturt testatrix)
u•u.c ut Ntat tirru• / nr rnnrc• rears r,J~ u~~e', uJ .er,trne! nttrtcl and tertcler m? e•r+nstrnint r,r
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Suhscrihc•c! and uc~knc,lrled~c•cl hc'Jc,rc' me hr JnHN F. B. CLARK .
g Jln• te•stutnr 1 te•shttri.i 1. uucl suhccrihec! uncl s?1•c,rtt to he fnn• nte• ht' _ RUPFRT
~ JASEN SMITH ARLENE W. BROOKS
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August 10 _ , 1y78_
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~ ROGER POITRAS
iLER:: C:lr:.i~T Ceti T~n
MIDSTATE LEGAL SUPPLY CO.. INC. -ORLANDO. FlOR10A EH.gve October 1. 1973
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