325 1st St RERF21-0114 NOCDoc # 2021108867, OR BK 19700 Page 1103, Number Pages: 1,
Recorded 04/29/2021 10:31 AM, JODY PHILLIPS CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
f?AWA'e IN DUPLICATE)
Pemtit No. _ Tax FORCounty -td tt
-tee
2WO Of FL
To whorl it rmsy cor%*M:
3'{ib uM®ssiafred hwauy ifi'ionids you fh c dlttpsetiettrarifs wig be bade to wdain reef proporo, and in
spoor& nee with Swan 793 of the Rorke bsrratas, the ioikoxirery Nt6oenratdan is sCstad in th&q NCMCE OF
G6�VtWl�'FfCL°G�i�'A14'. 1
LeFoi de or;ptiort of Prowly being improved,
Address of property being Improves:
Genorai doxrlpdon or Improvements: R �CiC
>_33
o wags lr`�i Brest In sift: of the hstpswovsran-ir
Fee 5lmpie 7 W31der (9 oihW then avn,, r)
Mar- -----
Address _ _,._ -
Canbvcior ROMP040 BRIMEPS ROOM: INC
Address PO 80X 930337 ATS ANT(C iEAC-H K, 32233
Phone No, 004-24"6* 32233
No. 904-246-4810 Address__-,_
__rlmotutY o1bond
---
Name and address of MW pf =, Indrktd a iaan -.or the oonshucdor, of the irrpm merhs.
Name _
Address_ ~�
Photta No. � Fax ND.
.-
Name of person within the QU* of F%ride. other Shan hlmg M dasignaeed by awnerr upon wham not pas or orumf
documents may be served:
Name DAatwYmjAw
. Address 155 LE RD�C $ CH322g3
Phone No. OU-610.OM -
-
In addition to hlmseif, owner desi=gnates the 1ollo;rrtg pusart to renews a Mpy of tate Liones Nonce es provided in y
Section M.06 (2),,b), Fdodda Statute$. (Fill in at ovraers opUnt ).
Mauro
Address
Phone No. __ _._ Fax 1`10.
ExpU'sUan pees ar NUt3ce c>3 ranmencantsne (tne eVhalion date Is one (t) yG& wor0 �G date of leaorddng Ur1tU54 a
different data is speeifed): _ r .
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