|
'� "�.e- . . . r . . •S �. .. ., ;r . . _ . :4. _ .
<br /> ' .(- r . _ �..�. ( t' , � l` kr?.1,. ��,r`�. `, `� �'`,'�� � , .. - . � i �.
<br /> .. � ' . � r •a: . ` � ' ._. _
<br /> , ` �:. , -- --
<br /> . .. . �,, < ,.
<br /> , . ,
<br /> . . ,:, • � --
<br />.. r ' 1
<br /> • • �
<br /> ��� ���� m-
<br /> • ���������Q�i��l��cs+ _�9ii� r�-.-..
<br /> _ �'..'F,^!",."'Z. - - �:'
<br /> �1fl4@of ��11rOPY1tQ . �:--
<br /> Councy at St�a �ar�ura. �:
<br /> � ��28��b befor8 rtte. y,�dv,e E tvnrin��, (�0�'�t.6 P!�l�t�._
<br /> �.'s'. �II � ttuneaARbdO�Gw(ag,d�.eQ13C�Y�+A7e1 e;.,
<br /> ��r�r��8� Miraur► �.-t'tim� , P,--
<br /> , li�rn(Ud�)
<br /> :�,�°' ��cer�a�,P tc�o�€m to ma��-�proua�t4 ma an tite hasis�i aait�4ac�nry ev�ancc�t4 de the Ac�rson{g) �__
<br /> whase narno{sy i�ls�su�scn'68si ta f�e.ov.�in ifls4:um�nt
<br /> and asla�awtedgr�to me thaR h�l.,�:iel�ey:ez3r�ttad ttte
<br /> sattte in hts/h,6t�`�eirauthoti�d c�p��'��?��Sttd that Dy
<br /> ,�r��<�. �i�aes hisii�e�rlt�eirstgnat�e(s}an��ns3�umant tt�a persanis�},
<br /> '. U ��.�,� � o�r�th�e. ent�i{ty ujpan heha+lt at�thi^�tita peraon{aj acteal,
<br /> 1"�' � "I'�. a�� 'rpsA+S'•� 011OW\VY 4N I��iw
<br />�,�� � � ~s' C�aF�as�p'' WfTNESS�tt�/hand 8�sd ei�1.'�S�6►t.
<br /> , �.
<br /> . � �. ��� .�,
<br /> ���'i�
<br /> ���16fi9� . -
<br /> 7TiotyA B��r�famtasla�QG�.9fs rtOt re4uiredbYJ9w,ftmayptto�vafl�abl�Oopersazs�on ff��iird Fend6awCyts'�mr.p
<br /> � fr�ferUramaval6lrbrsaftadurterstat tlrLs lorm to sr�i9rdoarns�nt
<br /> � � �ei��Ori o!Atta�9���u��n� �..
<br /> � r�ecT�ry�a���,ma� ��•aceo�5� Aaree„r�t — • . r:
<br /> � .. � . � ..
<br /> Dxucr�pttY� ;� :�'�•�"1�°1 Po • ,: t'i�mber ofi 4�agea �.,......— � :.
<br /> •� � �e�gy o'�z'ifa:��.�i�tfc-4�,�I�r�be: � , � , tt
<br /> �.� :<,,:,:;. , � .. :�:�,:
<br /> •. � � C��d3+�=���'����1�g��Y��t�a�s� ' . ':;-
<br /> � � ' , ` �',_
<br /> '°`: , S'�gnet's Namo: Signe�'s Name:��
<br /> . .,� ' ,
<br /> ..� ❑ tridiviifual . � . . 1� ir�d'ividsrat � • , � .
<br /> 0 �.�
<br /> - :e Q CprpOrat9 Ofit�1� � � Co�Mrt�t4 t�fr6ipsr `�,.' . ;I:.
<br /> :' T�Bei$?� .�::..: Zifle(s)' :, ..�: .� . • � . , ;''f;,=;.:-
<br /> � �t ❑ F�rci�i,ct�'-�O Ld'rts�ted O Generaf C7 PaMer--`�'�:.knnitei��;::::�noral ���:' '�-.
<br /> � , �9 ❑ AtiE�ay ftt-Fac� . . C1�Attomey-6,t�'s�r,t � . , . , _
<br /> '•� O Tr¢�'t�e . - :..: CI Trustes ..:;:.,�.�. . a,
<br /> � �O Qa�arc�n or Cotiservatot . . . . � Guet�dfa�t�r�ns�tvfrtur .;,:,�;�,
<br /> . �� O Otftes: ,.,�� Top ot tltiWrD heta O Other. oa o�mw�u nere •;;,;;:-
<br /> � , 5i�wr la Flepressriting' Sig�ner is f�q�ir,cfseming: �
<br /> ,. :, �
<br />. � �
<br /> ,,�•.;, . OS9Mli�WNaFRIAaocl�+•�lRMerfAyw.PA.(�uf19���s�P�A.fY+81809�7181 y . f.'m�dNo.3�6T, Rra�7:r:CaiTtLFrtat,UrA�DECF9
<br /> ,
<br /> ' . _..� : . ; . . �-� -.:� . : , i.,i' • �' . � - - � • � .
<br /> . .'� ' '. r � _.. � � � _ . .� •., - =.c. • .. ' . � n` '� . ..� - _ .
<br /> . :. .. • . . . . _ . .
<br /> ... . . � : . . .. - �
<br /> . . .
<br /> _,. . .. . .. . ,.., . - . ' , _. .. . - .
<br /> ,�. - _ .. ..�,. . 1 .
<br />� _ ' . _ . .b � . . _�. , .. . . • . . . . ' - .i�Fr, . , � , � .
<br />.. .____ ___'._____ _ __'. _,___ __-___. ._._.e. . __.,.. .__.__._ ______ _ __ _ _ ___._ . _ _ _. _.__.._.____... _____
<br /> .. . _'. __.. . .:.. . .._
<br /> . , y
<br /> _ . _. _ - -- . -_ _. _—
<br /> . •_ • . •. _. . •. .. . . -,-.� , � ..�, .. .
<br />. . . . - . . � �- . . .. .
<br />- - _ . . . � . . • - . , . . � � . . • . ,. - .. • .. .. ' . �y .
<br /> .. . . . .. ' � � � .. . ._- . • . . ' .}' ., .
<br /> . . , � . .. � .. ' .. `y . ..
<br /> ' ' � '. �-- ' .. ' . . . . . . ' �1.. ' ., .
<br /> . . • ,. r� . .
<br /> .. _ • . , • c�",'' ' �.,;, '��
<br /> ..._ - . . . . .-,,. . - � .. . . . � - . � .. . ,.. � ...,._.�d,- ' . •_,.. ._ . ...... .'....
<br />
|