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THIS STATEMENT Oee+ewrod ro . tiliw~ etfiw fer KGN peneewt ro the uwct... Cetarcial feM: >1. ller.riry /ero (if a+p): ~ -
i . D.lter(s) (lmf ?iwa Rrst) a+d al/ret+le+) 1. Secwed ,atn(ie+) ew/ al/n+s(e+) fw filiN Offices (Deis, Tia, Me~Mr, •w/ Rfiq OtAa)
Ralph Altenhoff t•7-ORIDA BANK AT PORT PIERCE
111 N. 38th St. so1.ORANQEAVENUE
~ Fort Pierce, Florida 334 Fi0RTP1ERCE, FLORIQA33450 ~ ~ ~ pp
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~ ni. ctwro..wr reiwt ro eti/iwwl fre.ciw~ Steroawi b.eriN fiN Ne_ 40974Q , URBOOk 290, paCJ
i fiht/ .ifh Clerk of Circuit Co'~ July 13, 11 78
S. ? Cewliwt/iew. the «i,iw.l fiwewciwf +tete.+.wt beh.eew fhe te+NeiN D.Mw •e/ SecurN f ~+:H -
wh. 6ewiw~ fil. weah~ ~w.• ~r.~" .~~e.~.~
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? A~l+ar• TM ac.n/ werflr'. right ewder fhe fiwswciN +10i.awf bew:N fiN we~bw sMew oheoe ro tN McOe+?I /e+cribel i. Iron 11 hN bew •.+ipN
i N the e+v~wee These wea aw/ al/re.+ .PNw iw lies i 1.
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9. ~ Mtee.e. Swwe/ /aryr rehwws the alloterel /escriN/ iw 11N 11 Frew IN fiw•wciN srote~tN beeriq file wethw show aleoe.
10.~ O)»~ it 1+••. All dweawien +1etaO terse{ /et as/ PefehM w ro becawe d+re at/ ver~w oes.ewt a CLey+er 101 f S Noe beew pi/
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STANDARD FORM -FORM UC 3
(1) Fling Officer Copy-Alphabetical AOOre.e/ Irlr e- (oict) sro», S«r.ron.f stem, stro et fl.rlM
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