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BODNAR_ANNA_5030224
A.R. R.10.2?98?94 No.5030224 Narne ~_Qt>J{~R__---!~~--------------------------_ Date certificate issued June_J~.4.,_J.9_4~by the Qo..mnto.l1-_P~ea.s Court aL __Ws.shingt-on,._-Pa-._ Petition No.__5212 _ /'A .........,~/7"'?t (/1 i_.A.:J~~~~~-~~-~~--y~--------------------------(Complete and true signature of holder)