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, . . ~ ' -----~w+~- ~ ar.;a.~ ~.~~ti a.....:.~ - _ ' _ - -~-...+-._ti .v-... _THIS FRiA/iCIPKi STATEMENT b pns~nf~d b a filiep offiwr for fili~+0 P~nuoiv to ~hs UMfora? ~awrw~rciol_ i 3. Malwi doia (lf ~ 4~_ wr~ L K ayrb ~r~ t. D~b~orW (Imt Noer Fi~j ond uddnss(es) 2 S~aRd Pbryr(Ns) and ad6wla) ~ffiar<flab.IFm~.rf~~r adFfiinpO~fia~ 1~73p~ it~ t,~ItiL I~LNi ~#ti 0~ . - a !t. ~ . . ~I ~Q GB~D F ' u?or ~ a. . . ~n ~~o a~so~o~s, .t~ia~n? ~r. r~rs. sLa~ta? ~3~0 4~' . 4. ,hi. fina„ono a~of.,e.M oa.n M,. folbwinp fpp~. 1n i1~ oi p.nO..,,h 1~ ~1 8 t q~~ '~t~e. . o N~ n~b ~a. ~ ~.a m a.~r. ~a.,~. oae~... ~ fa.,ti OGER POi~RA ~ - 0 or~.r p.~..,,, a.~?~.d h. ~ el.E . ~a ~.~.t..~ u+.~a s. a.ek if a.i. ? n» a~no. .ww..d b~r elwpt~. ao~, F.s. hw~. bw~ piao.a a, r» ;pcnn?ia«,, ~u~wr~ro:..a..a lwrb~r, ond wiFl plocud cn any add'itionol and aimtlor ic~shuMnf d~at may b~ ~o s~curd. ihis seot«rwn is fild wiMaut dr d~bta's sipn~mK~ to v~b o s~ariy i~r~d in ooiiaqnol. tG'b~dc ~ If ~ol ? JW'~wlY wh~Cf b o awwiry i~Nrqt In andlwr i~iidictioa wirn N wat bra~plN iroo this ataf~. D wNd~ ts pr~ocMda of th~ oripind ml~orerol d~wtb~e abw~ ~n whid~ a a~cv;~y irosrw woa qrfw.d, Cl~dt ~ if mwn~ Q Proe»e4 d Coibt~rul ar~ otao avw~d. ? hoducls oi Collourol ev~ ofw oow~d. No, of additiaai Shwts prMwwd. FiW wi~ha . ~ - ~ . - ~ . ~ . °y W s+aw~r.W (~1 ~s~a o~'K.. c.o~,.nt~.b.+soe1 STANDI?RD FORM - fORM UCCr-1 . _ . ItppnOrrd bY T~1~ ~DAAAS, Sec=Mcry cf $ta~s, S~!e of ilc,rt3¢ i a~.~ ~ : „ . . . -r- - . _ _ _ . _ _ 'a~`c o-~"_~-z;~ : ~ . - 3 . _ ~ _ _ ny_ti