I I ! F'D-340 (REV. ~24-4115) I .FIie No. rJ - / 'l-"' -t/i /(3 / h Date Received / I/ / 2 ? From ___r,....._e_--__..}..,.3_..,P ___ -_. __c....._______ (NAME OF CONTRIBUTOR) (ADDRESS OF CONTRIBUTO_R) (CITY AND STATE) l_d::....:.-.-:&~.......c__--==------ By _ __,(...... ; (NAME OF SPECIAL ~GENT) To Be Returned D Yes D No Receipt given D Yes D No D.escrlption: 3/l~+~l'/J~ 1':1""1 I 'I 1:? ~ -#-- i. • I I I ! ''· \ I NW 8491 I Docld:59168315 Page 16 ERR DucId:591633?5 Page 1? - Iii-w . 1 . ll I 11H B491 Page 13 3mm WW "Mb-m 11H B491 Page 19 pl f( ;1/#£J o~:e I ~r~1 \ 51- l?OS-- I Jtl 3 - - - - - - - NW 8491 Docld:59168375 Page 20 -- __ j· . ?24.4. Hi Ewe?m Mu. 11H B491 Page 22 Km% Mg? ?50 005? W3 (2-7?ij