HomeMy WebLinkAboutBURCHIK_MIKE_3147772No.3147772
Name __~lJRQIt=!;K~M=!;~--------_--:----
residing aL __J;3~_.A-y_~!-'-_f_~9_~_~9]L J.J.~_~s_t:r_~1.?~!].~_~__~?-_~_
Date certificate issued J..an.ua.r.y~-9th f -_1~33 by the
__C_QIl1!J1Qn_P~eJ~~t Court aL_Jj9.JibJ.n~t9J1_J~.St':::_
Petition No.__21i6 3__V_Ql __14
--~---~~~~~----------------(Complete and true signature of holder)