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EXECUTED UNDER THE PAINS AND PENALTIES OF PERJURY ON THE DATE WRITTEN BELOW <br /> AFFIANT NO. 1 2 WITNESSES <br /> Signature: � /�` Signature: <br /> 1I/ <br /> Print Name: . . Print Name: a.► 4x-z'-L . ►^� 111 <br /> Date: l� ._. 'vr <br /> Title: (circle one) Member, Partner, Director, Shareholde Trustee <br /> Percentage Ownership or Voting Interest: /0 % Signature: �$ <br /> Print Name: rte. f Ccri,nci <br /> WITNESS AND ACKNOWLEDGEMENT <br /> State/Commonwealth of .79,/.£ _,Li <br /> County of,1/4_014.,91.,..44/1., <br /> On this 2/ day of 7l),'yti , 201 7 , before me, bC/k7S t' . <br /> the undersigned Notary Public, personally appeared -J43 4.i ;k i.-J,c <br /> who proved to me on the basis of satisfactory evidence)to be the person(s)whose name(s) is/are subscribed <br /> to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their <br /> authorized capacity(ies), and that by his/her/their signature(s) on the instrument,the person(s)or the entity <br /> upon which the person(s) acted, executed the instrument. <br /> WITNESS my hand and official seal. <br /> • • <br /> t ' ) ; Y;^ ; DORIS .ROY <br /> -06 <br /> 6 r•_� ;.: MY COMMISSION#FF 192337 <br /> •U • <br /> - EXPIRES:March 12,2019 <br /> Notary Public R,,,t;„,•• Bonded Thru Notary Public Underwriters <br /> Print Name: -'RIS C . /go 7- <br /> My commission expires:Y114.4..A..4) 1.2, Oi` [SEAL] <br /> Site No:370764 <br /> Site Name:Vero Beach Ring, FL <br />