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NATIt~l'~AL C~~,NST~LLT~T~ON l.~~N-tA•~~, au•~•.... <br />N~Uaa~1 Gans~rucilon Aolt-~tYs Co, • Natloeut! Sstitatton Ca- • Nattoa~! PoN'te' P°~~ ~°'' N~t!°dsi ~tsat-A-Fs~t Co. <br />Phone: (2531-537--b717 <br />GtamCst~Y Nitne: <br />~;~~ ~: <br />c~M -.~ <br />P~ei3r Iit1 in <br />Faxt 1253}-535-49ti0 <br />CI'~~flt7` Af~PLICATl~71V <br />~tsiy. ItnGOmPI~ ~~ wiil f10t 0! ptir~ aedl~ privil~dpas. ~~~~(~ _ 5 a~ ~ <br />8ranrn ot Home Olfict <br />~r~ T~.~. - D~~ ~~ 8 -.~ ~5~ <br />~~ ~_ _~ <br />' '~a <br />~„~ ~~ - Z~: q? ~.~! ..~~,~. <br />~ <br />~.~~,: ~~.~. ~ <br />1~ W~1/~"~u~. {.lilf p~bA 0 ~ Q ~ ~ Q L~O~ LRi./ ~~~~~ w ~nn~.~.~ <br />LU C,wl D~rUr-~- -~P~n.-1` . ~ ~~o. ~ ~,~.~~~~.~--~ <br />IS Plwwcu~L STATEMENT nvat~6 Ci YE5 O NQ 1S YOI~i 8tl*INE55 PROP~IIY,~'J tf~SED IS lffluft F~M~ a OWNED 0 REN~ <br />pFfICER5 MtD! OR OYYNEF~S: . <br />I~~~ m~ ~~ c P"°"~. ~~" ~~ 5~S <br />~ 5~ +~ ~d -~~ .. .~ <br />OTHER EMPLOYMENT: ~,~ <br /># of ~ .~ <br />SAOUS~'S NAME: Post-it~ Fax Note 7671 Date 1 97 pages~ <br />From ~~ <br />To <br />Miqar 5~nk Credit Cara: _. __~ .~„ c. <br />F xn to COntut fo~ Payment: ~~ s P #~ -~19j,`y~ -' <br />Nittf! in0 AOCtl3i 0~ ~iink' / ~ ~~y <br />~ i~, 3~~ 7/~ Fax # 4+ ~ g g.. 9~ ~~ <br />Bfflk iCC0u~1t Ntllrbtt: ..~. <br />. `~~ J <br />~~ ~: G~ ~ <br />~ <br />R~ERENCfS; tist nune and ~ddceu ol lirrtf: wip~ r~hDm y0 fi~ <br />Camp~+-y N e /w,..-- ~r I St~e ! Zq Pf+on~f <br />t. <br />2. <br />3. <br />Tppe ot Siles; q~~~ <br />Sale Terrnoryr Ca+~aa0: TO VYham ? V~en ? <br />Wtr! you ever in o~rnti or pititer in i cpA~lly p~ tprporMiOA tlW 1113 (iti~! !Dt p~Aluuplty 7-_ <br />.....,~ <br />Ars Your Auess Pkoql~ ~s Seeutiry 7 <br />Es~~mut o1 Manthly HiQh Credit Neeoen t ~ (~j . <br />AN Psst due bilmces are su~ject 1a 1 se~vice cnarqr flt 1 tR~ pa manM (16"X Mnu~l~. Stfo~d Mction ae bro !o cou~i uyy lu~11S Dist aue. 0~{~~0 A`+~Y sh#II be <br />enut~co ta recovar coun caut at-o resotr~0le ~ttan~ey's kes. 5ee rar~e iid~ Ia poli~- i~d terms. .. <br />we,~mnn uw we ~n ~~nanci~uy:au a e+er~ commcnne~ we ~w m~ae,~a expea ~o ~r invaias in ucarouu~ wi~n -erma u~r~ed. . <br />6y s~~nrnq tnis ippt~c=t~on 1 unoer:t~nd qW i irn u~nprituq NCR! to duck my trea~ historyr. <br />Caao~ai-an ~ i an~cer to s,qn honc. u+oa+er to s~4n Qwnn~- on nw~se s~tle. Pirtner~p - t to sipn tront. ~non~er to sNi~ O~~Y on nrirse ~l~a. <br />:ea~v~a~l - Owner ro s~qn tront. spouu ~o tipn qwriM~r on reyecte si~. <br />p~ 1?- I G-~'i 2 „~~ Title ~ t V~~ 1(~ 41 u~t~-Q~ <br />SIC~VA'TURE: ~ <br />