who deposes and says that he executed this certificate for and in behalf of said corporation and
that the statement herein contained is true and correct to the best of his knowledge and belief.
Sworn to and subscribed before me this

(Notary Seal)

CORP.-60, 6-64

day of

Signature of Notary taking acknowledgment

Send Original to: TOM ADAMS, SECRETARY OF STATE, TALLAHASSEE, FLORIDA.
(SEE INSTRUCTIONS ON BACK OF LAST COPY)

1944

ORIGINAL

40-399 O-70-25

Insurance companies are not to complete item 6 pursuant to Section 624.0221, Florida Statutes.

Personally appeared before me.

who deposes and says that he executed this certificate for and in behalf of said/corporation and
that the statement herein contained is true and correct to the best of his knowledge and belief.

Sworn to and subscribed before me this

(Notary Seal)

CORP. 60. 6-64

Notary Public, State of Ficrica at Large Jayliner

day of

My Commission Expires Sept. 10, 1985

Signature of Notary taking acknowledgment

Send Original to: TOM ADAMS, SECRETARY OF STATE, TALLAHASSEE, FLORIDA.
(SEE INSTRUCTIONS ON BACK OF LAST COPY)

196

ORIGINAL

Insurance companies are not to complete item 6 pursuant to Section 624.0221, Florida Statutes.

STATE OF.
COUNTY OF.

Horida

14. We, the undersigned, certify the above statement of

Attest:.

Personally appeared before me. Cardell and M. C. Briley

who deposes and says that the executed this certificate for and in behalf of said corporation and
that the statement herein contained is true and correct to the best of his knowledge and belief.

Sworn to and subscribed before me this.

(Notary Seal)

day of

Signature of Notary taking acknowledgment
Notary Public, State of Mida a Large

My Commission Expires Nov. 1, 185

Bonded By American Fae & Casualty Co.

19.66.

Insurance companies are not to complete item 6 pursuant to Section 624.0221, Florida Statutes.

COUNTY OF.

Florida

Fron

Personally appeared before me.

14.We, the undersigned, certify the above statement of

Attest:.

шишик

Secretary

Joseph E. Herford

H. V. Cummins who deposes and says that he executed this certificate for and in behalf of said corporation and that the statement herein contained is true and correct to the best of his knowledge and belief.

Send Original to: TOM ADAMS. SECRETARY OF STATE, TALLAHASSEE, FLORIDA.

1947

Insurance companies are not to complete item 6 pursuant to Section 624.0221, Florida Statutes.

COUNTY OF.

Personally appeared before me.

Secretary

Jought. Hesford and H. 7! Cummins

who deposes and says that he executed this certificate for and in behalf of said corporation and
that the statement herein contained is true and correct to the best of his knowledge and belief.

Sworn to and subscribed before me this.

(Notary Seal)

CORP. -40. 4-67

day of September 1948

Hallonbick

Signature of Notary taking acknowledgment
te of Made at Lergo

Notery Pudsey

Send Original to: TOM ADAMS, SECRETARY OF STATE, TALLAHASSEE, FLORIDA.
(SEE INSTRUCTIONS ON BACK OF LAST COPY)

ORIGINAL