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Tti15 STATEINENT is p~s~nqd to o lilieg officK fer f:linp pursuoat fo tM Unifww~ Conrn~rcioi Code: 7. A1o~vriy doN (Ff mr): 1. D~Wor(s) (loft NoiM F'vsty ond oddress(~s1 I. S~cur~d ?artl(iesi oad addr~ss(~t) hr ~:r~ OH:w ~or~. r.r. w.~«. rw ~~y ONot Iriso~a~ ~u~eue t ~el'S0nS7. f~11'~t P1g1~IZ1C. F lED ~yp ~EC RDEp ~ 503 ~ctid Lanoe p,0. Hoz 38ld il~ wciE cou~~r ft~l '''oY'$ ~.91'09~~1 ~~0 112 SCtI}~1 ~$h +~'~'.1*98ti ROCE%c 801TI~A,~ g C1ERK C~zCU1T C01lRT ~ Fo2't P39r~s ~ ~2150 ~ RECORO YERiF~Ep ; ~ ~ ~ 1 Thia abtMn~n1 rdvs re nwiq~ieol financ'ap Srahiw~M bprirp fil~ Ne. - 2 , j~22 ~ j~ /r~ ~i~~~~' , i~led wilh~t ~ y v`~ ~eW~N ~ 7 h 9 1! S. ~ Cer+tinuofiw~. Th~ wiyind /inoncieq stot«+wnt 6Nw«n tM fwrpoinq D~brw eid S~tw~d ?ort?'. bo~irq fil~ wwwb~r shown obow, it st~) ~i/~diw. o. F~ Ten++inotion. S~cur~d pory we lonp~r cloi~s a s~cvriy int«~st vedr Nr fiw~ciny NstMrnt bta.ie0 fiM iwmbM she.rn abur~. ~ 7. Atsi9nmenf. ~~cur~d poAp's ripM wid~r N» finoM;ep aw.~.w~ b.o.~np f~M ~ ahown obow ro ~h. P.eo.nr d.acr~d in I~~w 11 !wi b~~w ax{pyd ro eM essiynM ~rAow noiw~ ond udd.~ss app~s in INw I1. ~ B~ Am~nJmeet. fw~oncNq Slahw~t b~wieq file eumb~i sAown abow h orw~wd~d os sM forM in ttwn 11. 4. ? R~leos~. S~cw~d lory rN~as~s 11» colloNrol d~crib~d in Nwn 11 fre~ IM firqnciny stohwriN b~arinp fiM mrmb~r shown obew. • t0. ? CMck if hw. All don.,Mmery seo~ap toa~s dw «d varabt~ e. a 6«nww dw and vuroW~ pwwaw~ a ChoWK 201. F. S. Iw.~ b~«~ po:d. ~ 11. f ~ ~ S ~ _ ~ ~ ~ Ni. Of.O~iti0i10~ t~NM{ pf~~~~l ~ s ~L7~/1~,6Y ~ dV{l!1 `II~K sr: ~r= siae.w..c.) d o.b1..t.1 tn~o...vr oel, x ~Mw ~ is .ooiica6l.). siq~s+Yh •1 ef s«w+a r 3 STANDARD fORM - FORM U~C-3 , . . . , , . . ~ . ~....a s, rar? ~awt, s«..~~,, ~ s~., r~...s. ` ~.s'-~. < ~ s -`~,s - , ` , . ~ ~ y Y - . ~v ~ _ v