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o ,~;r_!~,~• CERTIFIED` COPY i
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1? I hereby cent ~ ~h~•9abbE to be a true and correct copy of the Local Registrar's
record on fi.}~i.(~ the B`" ard.County Health Department at Fort Lauderdale, F1oriEla.
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(Warning-Not va,lidr-un~~s~ raised seal of the Broward County Health Dept. is affixed.)
- _495585 Coun Health Of icer and Local Registrar ,
~ FILE IMC FEC EO ~
3-25-80 ~ ~cP01 ~~~A• Chief D puty Local Regis ar
RC{NT C011RT
RECORO VERIF!FO__-- BUOK~ P~Gf~~
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