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10. Aadress(es) at which you 11ave lived during the preceding five years (begin with present or <br />last address, and work back): <br />NtYmber and Street <br />City, State, Zip <br />Dates <br />I� �-(�'��1 i�I'�c� ✓� tl.� r�-� �- n..1 L, l��'6 ov- l--e�,�C',,►�..J ���1 'Z 2� l I—�►2��� <br />��'br`I'�� <br />I �--I ►-E `�`�a �`1G�c�L-( ��� I.LCC1 TI�I`1 l :� �V�i lJY �.-Gi.� � YYl-1� ��� � �-� l I <br />11. K111C1, narne, and location of every business or occupation you have been engaged in during <br />the preceding five years. (Begin with present business and work back). <br />Business or Occu�ation <br />Business Address <br />Nature of Work <br />� 1�.� V�1-c'�;l �►� C1 C)�J����"ci QGt,�v� ��'Vle�Cc� YY1.� 1�i'�'?� �U`i-�=c� �-LG <br />v� n� � I Gi�1 I ��-i �-1- �� P�� ��,��e��: 1 nC��h' �-n� C�:-1--I-r�c f�cn. i. <br />12. N�mes and addresses of your employers and partners, if any, for the preceding five years. <br />(Begin with the present or most recent and worl< back). <br />Employers or Partners <br />Business Address <br />Dates <br />13. Have you ever been convicted of any felony, crime or violation of any ordinance other than <br />traffic? If yes, give information as to the time, place and offense for which convictions were <br />had. If no, please indicate so. Do not leave this section blanlc. <br />Page 8 of 10 <br />