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" Jw• A. T•nt•~ Nal• Jonuasy Z6. 1976
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Nanh in~•sal !bM L t 1521 MaaDington St. Mauk•gan. Illinois 60065
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~ ' (TATS OT ILLINOIS)
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I do hertDy certify the above to to a true and accurate copy of r~'~"
a Vital Stacisttcs record en isle cn the Otface of the Lake -
County Clerk. Certiticatfon noc valid unless the Official Saa1,~;,G.
of Lake County, Illinoas as affixed_ i~
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