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HomeMy WebLinkAbout0422 ~o ; ~ r _ - o • - . ~ ~ . • . . . . . . ~ ~ ~ - - - - . , _ _ _ . _ _ _ . _ - ----1. _ . . _ OFFICE of VlTAL STATISS'IC~ ~ _ ~~i~. O1XON `i'' CERTIf tED COPY ~ R» i„~„~,~~~ ,an~ ~ . Dx Tax i.-.~~...~~ d~tl~ ot p uit ~s'`; ~'{~y~~ tat'~c ~ ...~..........8~r ~ Y ~~1 ~ MIV\~ Vr ~ ` ~oc.~fwcKO. ~ FL4fi10A lk~uEy Llerk ~ ~ ' ``a ~ ~ec:~oE?ti s k~ .,c. ~o~a c..o - t s~K ~ R CliARD J SE ~ ) E+AtEOf flElaN({infiM? Oqi 1Mr~ ~ soeuu eEa~nr r~weEp u~~ BnYd~ Sa VNOlA t ~EM x u?+o~n ~ ~ = Pt0 E 9 - - - ~ Rp+pEOi0611H(4pph,Q,t~r) 7a1H1MPlqL6~t~a0SIMraFO~~CcWiYy1 SYIa60ECE0EH[EVERINUS y. ~ M4E0 FORCE~) f~at p ht~) ~ 3A UARY N 'a' s~ r~r~air~~~c+~.~•arr.c,.:...wr~„«o~.o~a+++v~y ~D WSWEpfvttWtS~M+nrNo1 f: 4~p~Mt~ fAlOiAp~tMr1 i 1 OOA U N~wY+4 »Ote~ ; i ANid~wc~ LIOtl~ (i~eo~y) Y r~7U1Y ~M~lf 0~ r~0~ Ms~r09n. 4'a~ ~R~M MO ~v~nbr) 10. d f V. IdMt~t ON lOCN10N Of bfAl M OOU?11 Y Of DE A1 N - ~ ~ Y tiCA C ~ •f ~rrf Pft~OEM~~p6t1A10l:G1~u~fON tObKY1DOF6t15MIF35AqOV3tAY 1/ ~~-AWrNd. 1! ~1RYIVR/~SP0~19EIM~.p~wu~nn~+n) ~ UNi7ED STATES GFfii~~R E Qf?K -~ra n~s+vfwc~ SKre qo ~O~+nr >>c aTr.~. on c.ncwr~o?+ ~ae r1aeE~ ~t+~++u~DEa Flfl~ttDA NASSAI} ffRNAt~1DINA BEACtt 2043 MARLiN COURT ~ ~ a. v~',~DE Ct~r 1~ 2iP CJ7~ t~. M~S DE~OEW t OF ?nSPRt~C Oq ?Wf W+OF~0~7 tS MCE - A+~a~can b~0~~ ~a OECEOEN~ ~S EOUC~ ~aN ~ t W1 rS~ n~r s~ (SVay /M~ a 11u tM. ~sNrt. QiOrr. IM~ew Na f~'h e^h ~N P~oe ccv~~' ~ NdeM. ~fA~o Pow+~ de l~ 1Jo Ll lrbs ~ ~ °C: M 32~34 ~I~G p•~ G°t~n ~aS.! i~ 1~??+EA'SN~V~F /Firlf. ifiA~ t~s~1 ts ~Aai!!ER'S NA4E l~C Yldl~ A~Mc~nSlnrNwt~) a_ ~ JONN A. ROZMERSKI - CA ERIN CYGAN ~ ,!~+t n~sor~~rrsww~.p,~p.~.,+w ~e..w~wa~eoa~ssese..r«~a+rr,~+wow..raoe~rr.n~e.ccarale.~sraaz~+coo.~ ~ NftEN R. ROZM£RSKI N ~ : oa ++~Et+~oo oF aSAOSr7~fA~ 2on Pc1iCE Uc o~PUSfnonp~E~rsarowryarX c~imb~t a 2a~ l~lOqN - Gr d rern. sure eY+~r ~bey = _ ~ . ~ _ Bv~M 7? Cw~MI~On f~ Alm0v11 I+Orn $yY " 6flSQUE 8EtL4} -CENIE~ERY F~RNANDINA BEACH, FLORIDA . , ~ p~,na,on , ° a~w Iso.NM ~ ~ 1 t• S+~IITURE OF f utE?u~1 SEIRAGE tlCF?+sEE OA 2~b i~CEN8E txt1.1~ER . 2~c ttA6E MW ADORES9 Of F/1UL1iY ' ~ ~1 °E~o" ~ssuc~' ~?~'°~'~°y. OXl.EY=HEARD Ft1NF~2AL HOY(E ? ~ 93a f3~ {ITtAN'~tC q11E.; F8d~Y1t~DtNA BEAp~I, FL. 32034 ~ ~ a o~ k tmm i n Mw ~in». da1~ ~nb pJ~ra and b~t b or ~?3~ On ttr bst~s d R~i~Mb1 ardfir'vr~sfqliar~ m ny opinlm deam occu, roe st ~ p Yw Hw~. dM~ erd p4t~ ~N cRN cws~[s) and e+ann~ d w~~eA _ " b~ w «w ' j ~ '~~~r. `n' . f'..~ J~ ~ w».~e ? . . A , Q ~2b 011TE9dN~(W.D~f:ftl t2t.HOUAOF[IEIQH Zb 0~ N~A(1ke:Dycltl. Qk FIOl1ROf ~~n ~ . i t~ ! E~• 7:46 A. M ~ 1 a g tM t1AMf OF ATtE1DM1O RiYb1l7M1 IF pifHER T?tAN (FAi~IEA (~e e~A'~x) ~ 21d. PHONOUNCEO GFAO (Mu. 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S!~ro! ~ . ~ - eCee~. ladorY. ~ (~jY1 _~o aa . ~ ~n51 y . ~['~=T~~f ~ . } ~ U ¦ ~ t $~~7~ 422 ~ ~ THt& iS A CrENTIGtED TRl1E AND COftRECT COPV OF THE OF~1CIIlL RE tN THt$ OFFICE ~ ~ t 4~Qo ~ ~ ~ F ~ ,~eT~ lY .BUdADE ' ~t% r : BY: !e ~iegisttar ~ ~ _ ~ AMV tpN CF THf9 OOCIMAEMT 15 PROtfB7TE0 B7 IA~Y. DO HOT ACCErT ~ ~ WA~~ViNG• ~E SECt1R1TY PAPEp WITH COiORED BACKORO:N.D Aht~Ci'JtDE1.w~5EUGpEAi _ ? • 6EAL S2ATE OF FLORtOII ALTlR/4TiON OR E'FtA JFF . a~. rn~v.~ww+or~cv- tt F0.4M ~`.h4d ~i-06; 3'~. . . _ . . ~ _ g . v ~ F. , ~ _ ` . _ . - ~ ` ~ • , ~ ~ ~ • ~ • ! ~,,x,- ~ ~a~~ . ~ yx'~„X 1'~" A y`y"`~ `a _ .~i'~ x~-. • ~ f~, Rw.' ld ~ .taa~ e~ "e z`~~ .~.S~St t'~. , . . Q . . . . . . ~ ~