EFTA01250967.pdf

STATE OF FLORIDA • OFFICE of VITAL STATISTICS CERTIFIED COPY CERTIFICATION OF BIRTH STATE FILE NUMBER: CHILD'S NAME: DATE OF BIRTH: SEX: FEMALE C w C CC COUNTY OF BIRTH: PALM BEACH 2. 0 C CC DATE FILED: .J IL 5 MOTHER'S MAIDEN NAME: FATHER'S NAME: DATE ISSUED: MARCH 15, 2007 RED: 2007248136 I tiE HONE CAOIATURE CEPF€S TIM THIS iS A TRUE MO CORRECT 0014. 0 Of OF MU& RECORD ON MI In THIS °Ma niO DOOMMO 0 ;mom Cs, mmicC0440 O MOW. 'Ann MIN A vmDEP/Mar Or T4r AMA' WARNING: leAA Cl The suit°. KoiloA 04 THE micol 0.4 Imo( CONTAINS SPECMI. In •• - t • AND SEALS IN 1144.14004110WC Pe, Cm FORM if44 10644) CERTIFICATION OF VITAL RECORD MM16-31E-MM-108062-GJ-1A SEC 004 SER1A17-1A19-000436 EFTA 0(1077768 EFTA01250967