|
�UN-�6—�@8? 1��45 �A�BLI�G C�NTR�� �ORRD
<br />` �+9i.��r��sr��`� �.��,rfr�� ���b%�� .
<br />�...���� � �����iN#��► '�i��" ��+�'#'� � ���"�1'�
<br />An ex�rrlpt ��r•��i ��y 6e i4�ue�i �� a flp,tprr�t�i prc�anizakiqri ��"�
<br />ca��ucting ta�rFu� ��mbling activity �r� fiveot ���rda}��, an�
<br />' ' aw�rdir�g l�ss C#�a� �5d,CC�O �rs pri��� �+st�rsgs a caf�d�r v��r. `��i �' i
<br />. ,.,..�.,,-.�W-,..� _ � �r..��.�-�,�-<��.:.
<br />_ �:�'�s3.:f[^�R..�.,FSi�"AWL.`rR, i..k8.d'd98 B�''�kY"'-�d.�'N'1,kf3N.a'%� R:.8�..6d%p' � � �
<br />.
<br />, ,.... . . , .
<br />��I"."j't3t1SZr^.t�,it�i1 17�Y�1� (
<br />`�. � '��.� ��_�.....��.� ���� � ���� ��
<br />----�� �� -
<br />Type �i �orlprd�t arg�niza�+�n. rkse�k ('�� �n�.. _ .. ._._
<br />6516394��4 P.��I�4
<br />f'ays 1 rt 2 ��b� ��
<br />��� ��ra �� r���a��
<br />�..� F� Paisi,,,��,�.
<br />�''��i"�� ct�eck t�to ,,. ...,�.
<br />��� ��� �.�
<br />� . ., . _ . : ._ . .... �,��._,.Xy,ya�:.:ww.:...�..Y4 . :
<br />Preuibus ��swf�rl g�ar�sblin� ��'�� ion nbti����f � i
<br />- . ..._. _, - --- �' � ��
<br />� T�I'�t�"t�i�� � �'�II�iDU5..,. � 1%�f� F.�'��15 � �i��'C �It7Yl�1i4�� 4�IIttlZA'�197E1 _ 11 '��w„
<br />� ;._.� ,.i�;�,w�, s �"4 i .,.,� . _ .n'e � ',AdLE31.GiLi InUCJ�' �
<br />. —� _ � ._..�..��._..,_.�_.._..,_..,_.._,._.... ...�..,,,..�._... .—��.__ _:_,.. .
<br />.�c. �:�'TlE? <:� f;t'iif?F �?1ire:1il1i1F? C,]ii3c'Nf- ��.rtri .✓' " 6 t 1'la�;fim�n rtib�nnr.. rsi�mk.nr
<br />� , o � N ..ti�
<br />: : ... . .
<br />- W .. .. . ����:� ��::i������"�r"���~'�� . . _ .. . .
<br />�he�k ��r� vf L'�te fnllss3�ring ar�d af�taclx a�rapY t�# Yoerr qroaf aF' tt�atlpt�� ��. .
<br />NE77'�� ;��l�� �ctx e�sn{�t �a�ss pr fetlera! Ia �s�pic+y�'r r�erm�er5 e�t: noE pr0�f �f 3t�cat'� C3x
<br />�
<br />. A,,,�4- twlt�ripY�i'�i�Attie�esoi
<br />�n�r�rparafiivn
<br />�R
<br />Certi�sc�tp af Gaad �t�i��iing.
<br />1�itar:l� � G��ry t�f y��jr taC�ani��ttpt�`S
<br />N�€�proii� A�ifcie� di in�c�rparafi�sre
<br />Q�t' Gl.ES€r?Ft� �11t1'fi�Y� x'F L�0�1i�
<br />� ��, ��I�t� �
<br />?'I�is r�attiri�ats m��. �e ab'taitt�d
<br />e�aft year i'�orr,,
<br />��K`xei�ry OP State
<br />�usi�tess �rvi�s piv.
<br />��{} �t�ie t�'ffi�� 6�ildir7g
<br />St aat�l.l�ihf ��15�
<br />Phrsr�e�. $51-2�C"a-28CS3
<br />int�rn�i Reven� �r�ricr� - na��ian�l vrga�E�
<br />�Fsec4c i�p�r9rs'F �r�viausly SuY.stnikbed t4 G��
<br />�tt�c� a c�apy o` the Il�� :n�t�� ta�c ax�mp
<br />±+.,� ��argar�lxatiqrr's nemc�. Tt� c��,�iR a c�pY �f ;�
<br />exan�pt i�tt�r, sa�d yput federat tp nu�3�er
<br />rsrg2t�iz�ticn tnit�Slty ��t�aii�[ f9€' 4ax �x�snpi
<br />f iA" s
<br />C'.U, 8tS1C �50$. Ra�s'f1 �i�F90
<br />Cinr�n�ati, �7#� 45��i
<br />C:�SUfl�y
<br />', �
<br />'�.�:
<br />_�_ 1e�ternal Revenr�� S�nrica-�Rffil"t� afpar�nfi ctanprdfi�
<br />ar�ar�i�atian (�ha�ter)
<br />,,,�, Ch�k if pe�a[�f pr$tiinusly sut�m;t�es� �a Gambi"seig Ca�'tirol Boar�i.
<br />Q�,
<br />,,� If y��r or��trt�atinn Falis urtti�r a rsa�i��al r�;��ni�tir��,, �ach �Sat�
<br />of the fciiaw,n�:
<br />a. a crspy ot ihe i�S i�tter shvwin� ih�t yaur nai3onal org�r.i��tinn
<br />h,�s is�n a neg�stered nonRr�Fit 3CY't(cj cr��ai�,�5on an# �tri�s
<br />r7 �fYlllKl ?Sl���'IC„�. �MOi
<br />h_ � 4n(+u pf thLa CM�rtc�,.r Cr trn�ror ffQT }FOi:f f"Gi�e"1i��+2 Qf�%3i�lc»d'u'vi"�,
<br />• rac�gt�l�ing ygus c�r��rri�tian �s � �bord�nart�.
<br />_ .... : , _,..;:.., w.�.:,�_. � . � �
<br />,.,�......�._.��w...�,.�_...:_....... _�.....
<br />� ���rne nr" pr�rnis� vahere +��rr�t;ling � €v?�y �+ilt
<br />� �� �as.�.. � � ,� ^ {; .� �r �#
<br />�nducted (�pr' ra#fles, 4i�k kite si�� wh�r� �h�; dr��r�ir�g +�ili iai�e pl,���j
<br />�8��� � �
<br />f�tidress tidc nai us� �'t> t�ax) �' �i CoC�4 County
<br />� .�s.�� �,lP������.. ����'-........�.. �1:�.�,�..L �.�i��
<br />..........W. . . ..._ ., .
<br />Dat�fs� c�'�: Aiv�Y (tar ra�t��, i�dreac�: tri� dat� af t�s�s tlr2V�rf�t�j
<br />_��:�.�" ..,��,�,�,i���� , �.�?.� ---- - .........
<br />C�tzcic :he t�cx�x��.+s Sh�t i�[ � th� ty(�F: v4 yarr�bliru,� ��t�viiy y�ur qfg�t�i��tinn +�+il1 i�e cand�ctirsg,1 ... ---_.�
<br />. � "Bin�� M��ffl�g 0 "R�t�diewrte�is � '�lait_��bs � �'�i�abaar�3s
<br />.'�iing equ�prsw�� fvr �aul��tabs, rtpbv�tir�ss, padd�w�s�ets, �nd btrf��i (6ingn pap�r,
<br />l��rd r,�rdsf ar�d b��gta r��,�tES�r s�tec'�on c�vic�:) rntsst �� ra��irr� ff�rrr a dls�ibutar
<br />lit�rsse�3 i�y tFt� �n7�[ts�c� Co�,Cral Brsard, '3'0 #lt�c# d licerrs�e!' dl�wibu�r, go icr
<br />yrvwruu.+�ct7.stat�.rtrrs.us �n�i ciic[z r�n i.t5t vf �3cerise�r Ais�xi�.,Cat�s. �,1r caii �i�,3,-6�-4{3bi�.
<br />�`,`� � �`� ��� ��.�t...� � �� ,� ' �--•���
<br />�
<br />��
<br />��
<br />r
<br />•w" �'
<br />ti:
<br />�
<br />. N�%
<br />
|