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~ OPTI<'' Al. FOfiM 175
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's ~~y MARC~1975 • . • •
DEPT. OF STATE
- 50173-101
Certificate of Acknowledgment of Execution of an Instrurnent
~ii~ o~
(Country)
City of Oporto
(County and/a other potttical dlrssion)
~1Sllld~ Of tI'1e Lk]~t'~ $~tES SS:
~ (County and/a other political divieion) ~
of Ame,rica
4
(Name ot forelan aervice oftice)
~ I.. _Ivis ~arini V%c,~_~cisuZ
aj the United States of America at~~A'- Foitu9al w~~___-_____ f
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duly commissioned and qualified, do hereby certify that on this__~--w --20th ~
~~y o
f--^Jtme, 1986--~--~----~efore me personallY appeared _Jaime_Ferreira Ra- ~ i
(DATEJ
drigues and Maria R~ios l~a., Fierreira
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ta me persanally known, and known to me to be the individual~cdescribed in, whose
name~~subscribed to, and who executed the annexed i~istrument, and being
infornied by me of the contents aJsaid instrument~~duly acknowdedged to me
that_~Yexecuted the sume fieely aiid voluntarily for the uses and purposes therein
menrioned. '~?78~j1~
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; !i~ witness whereof I have he~eunto set my hand and
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oj~cia! seal~ the da and ear last abave written.
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Vi of the United States oj America
- practiabb all vgnatures to a documtnt ~a~ld bc induded in one certificata BQOK 5~~+ PACE V~
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