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Page 4 <br />secre�ary <br />LAST FIRST � FQLL ffiIDDL$ NA� <br />Residence Addres.s <br />Residence Tel�phane Number <br />Date Of Birth � <br />Treasurer <br />LAST FIRST FVLL �IDDLE NA� <br />Residence Address <br />Residence Telephone Number <br />D�te Of Birth <br />C. The full names, residence address and telephone number of <br />al� persons who singly or together with their spouse and <br />his or her parents, brothers, sisters, or children, own or <br />control an interest in sai.d corporation or association in <br />excess of five (5) percent: <br />�. Fu1,I Name See ot+�tGhed <br />r�,sT Fz�sT <br />i�IDDLS NAMS <br />Date Of Birth Interest $ <br />Residence Address <br />Residence Telephone <br />2: Full Name <br />LAST FIRST FIILL �IDDLE NA�E <br />Date Of Birth �nterest $ <br />Residence Address <br />Residence Telephone <br />3. Full Name <br />LAST � FIRST FQLL �IDDLB NA�E <br />Date Of Bir�h Tnterest $ <br />Residence Address <br />Res3dence Telephone <br />