|
rn
<br /> m � � �
<br /> � rnm � � rn
<br /> � �� � � �rn � rn
<br /> a� �o rn � p o
<br /> � �z � � z� � �
<br /> � �� � � �z � �
<br /> � z� �' � �rn � z
<br /> �� o � �ov � cn
<br /> �� rn �� �
<br /> rn� � � =c�r� o�o �
<br /> �o cn � � �
<br /> �� r�
<br /> �..r��:l�'[�l�1N���V�STI�I�'E[1dI�N[�' o o � �.�. z
<br /> FJLLU,�+1�NSTRL�TI�NS Q� . . �1]
<br /> � � �
<br /> �,,�1r�P�lE�PHCNE QF C414TACT AT FILER�opti�r��l� � Z
<br /> �.'�.�.��.�1.���4�����a�-�$�-���� �
<br /> �,��[L1AIL C�NT�CT Al':�IL�R ra�ati�rial}
<br /> �a�t[in�n�d�c��a�ns.4r�
<br /> �.�EN.a A�'KN�J��ILEC�GM�NT T�: (Name�nc Addr�ss�
<br /> ����� �
<br /> 4�1����6th�Str��t,�uite��4
<br /> L��i�o�n,.�.������
<br /> � �1
<br /> THE AB�VE SPA�E la FdR F1L.IN����IGE E�S��NLY
<br /> �.�E�T�R'�N�ME: f'r•��r9cf�anly�ne�e�[�r n�m��`[a Qr�b}�us��x��i,full rame;d�n���mi#,modify,or��E�r�viafe any part�f the C}�btQr's rame�;if ariy��r`af#h�Individuaf Qe�t�r's
<br /> n��n��viEl not��t in[ir�1b,1ea�re ail aF item 1 f�lar•k,�r��r��� �ard�roa'd�:th�I�,�ivf�ual��4kQr ir'�rm�tion in i:err��4�f Sl1e Fi-�arcing S�a��m�nt Addendurrr�Fnrm i,f�;1Ad)
<br /> --r_,............_.._....... __..�r�---
<br /> ".a.�R��.I�f�,�T:�i'V"a;'VH'�1"�
<br /> �alm I�i��ts,.�.�,�.�.
<br /> ............................................_. .. .....�.......................................�..._....
<br /> O� �b.!N�]1JIQU��'S SL11�NA�IAE FIRST PERSOItiAL N���A� AL�L�1T171�AL NAl1�6E�S1lIN:TI�;.�S) S;JFF[X
<br /> �c.i+AAlLIh1G A��R�SS ---•.� ��17'Y S`�+T� P�5"i"�1L C��E ��4.JN�F�Y
<br /> �5�:� ��ut�i I�u�.�Y�f�t. ��r�n�l I��an�. �T� ��Sa1 ���.�.
<br /> �.��gT�`JR'S NA���: Pr�v��e�nl}i��ebto:rarn�{�a ar�b;t;:ss exa�t,�ulE nam�;da n�r.:,rnft.r-rod�'y�or ab��eviat���,f�art�f tFy�L��btors nar;�ei;iF any nart t�f t�a Indi�idual�:7ebtors
<br /> name wi�l rct iit in;ine 2�,1ea�r�all�f Itam��l�n�,vha�'�c ner� ar,��r��iz9e t��a �7di�ridua���t4r infnrn�-�lnr,:n it�r>y 70 of tl��=na«cinq St�k�r�ent�d��r;dum(For�r L:���A�}
<br /> �
<br /> ?�..QRGAN:.�aT1Ch!'�h1�h�1�
<br /> _...._,,........_......-.. _.,.,,.._.. �_____..__.................... .,..
<br /> ��.11vL�i�IQI.���'S SUF�{�Jp,Iti4F: FIRST P�RS�f�AL NAA���. �lrL�1710NAL NAME�S)�INITIAL{�� �!JFFI�C
<br /> ?�. AIAI�[NG�,C�Of����S �ITY �. S?'P�;E �aSTAI.�:-�]D� i�7UPJ7RY
<br /> :;.�E�I��EG P}�RT���NA1��tar N!�1v€�❑;r�SS1G�lEE+�f��SI�NdR SF�:LIl��❑F�RTY�: Pr�vi�e an�y�ne S�rur�d Pa�l�+nam�;a�t�r�b)
<br /> ..........................................
<br /> ..........................................
<br /> 3a.�7RGAhlIif�Tl�i;�l'S fVAt�1�
<br /> TJ� �;m�l.l�t��x����:�dm.i.nistr�ti�n��[�,�I�:����
<br /> �� 3h.ll�'Q]Vf[]l1AL':`s Sl1RhJ.���fE F'IF�ST PER.S�NA4 hIAME AO❑IT`qN�L{V,�M'�(5JJ[6WlTIAL�S} SLJFFI�€
<br /> ......... ..............W..W. .._........ ..........
<br /> '�c. MAILIN�F'��i:�F2F:SS ��i�Y ST,�`f� P�S-AL.C�G� ���U�I�F�I'
<br /> 4������th�tr��t��u��e Z�� LYri�a�n �.I�a ����� i,T��
<br /> �d.��1.�..ATE�AL: Tihic=ir3an�:ing�;Gl�m�-tt c.or�r,-:=the fnllaw:ng col[��Yr�:::
<br /> +�qrxipn���t,�"z���.�'�,�3��tl Fur��tur��ir���udix�g a���prn���ds aitd pr�c��x�#'��,����ir��w�ifh iva��r prc�je�t pro��e�s,
<br /> inc�u���n����.x•e��.a��x�����ts��td���b��Y��ti�us,��h�r��rer l.oe���d.
<br /> �.Gh��k onlv if appliG�}�le�nd��eGk s�ane b�x:Callat�r�l is he�d in a�-r�ast{se��1��1�,d,item 1�I an€�]nstru�fiahs', �heing acimini�tere:d by�a Decc;dv�it's P�r��'l�i R�preset�fative
<br /> ��.Ghi�ek�.�i�a�plir,�hl�and checF.��:�r an�b�rx.� 6�.Gher,k,�if�p�al:��f�l��r�d�`��cic,o„���rt�b�x:
<br /> �P�bli�-F'ir��rii�7r�r:s�c:ian ��rlar�uF�,ctur�:rf-f l�rne Tr-ansactian �A�5e�tar is�Trar7smiitin�Uk�3ity u Ar,�ricultural Lien �Nori-UCL'Filing
<br /> ?.�,�T��iVA�I'v'E❑�.aI�NATIC?N fifapp�`�,ble;�: �l..r.,.:,��t:..�ssar L, ��..efC.�nsl�na�r ` �
<br /> ���si� � ' � �,ellerlF3�er E3�31�Fi1?ail:�� Llcenseet�icena�r
<br /> 8.JF i��CJAL F1L.E�.�EF�REiVCE C7�11"A:
<br /> In#�rnati�na��.ss��i�tion��Comm�rci�l Acf rr!l'nis�r�t�r-s�IA�A1
<br /> �tLiNG�FFI�E COPY�-•-lJ���INA'V��N�STAT��ENT{F�rm l.lG�:�`,�(i���.❑4,'��1'I�� ���[���
<br /> ��
<br />
|