AFFIDAVIT OF RESIDENCY

STATE OF FLORIDA )
) SS:
COUNTY OF MIAMI-DADE )

BEFORE ME, the undersigned authority, this day personally appeared

________________________, who being by me first duly sworn, upon oath, deposes and says:

I, ________________________, am a resident of ________________________________ (street

address in Overtown).

FURTHER AFFIANT SAYETH NAUGHT.

_______________________

(Resident)

SWORN TO AND SUBSCRIBED BEFORE ME this ____ day of

_____________, ______, by _______________________, who is personally known to me or

who has produced _______________________ as identification and who did/did not take an

oath.

_________________________ ________________________

SIGNATURE OF NOTARY PUBLIC PRINTED, STAMPED OR

STATE OF FLORIDA TYPED NAME OF NOTARY

My Commission Expires:

____________________