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portant information about your statement (Continued) tinutd) thivithalmaity arts The tamation data Ice inianlial on mayor may not relict cognomens Oates ate Seaway reorgricaion eons DOOM and other remorrane eats and amok pad a. tots are each combated to disinal one award Sie the • trade dae' colon
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ss 1. (street Address or taliOn) County: (Ch) Dales you vie be at Ns address: From: (Slats) PO) To: 2. (Street Address or location) (Cis) Oates you will be at Ws address: From: (Slats) (Zip) To: County 3. (Sweet Addresses location) County: (Ch) Dales you we be at the address: From:
sidence (Replobstion o) 4. 2008 Other White Little C (Yew) (Wesel Type) WJ1F10188803 This vessel is: (Ccrorroolor Scheme) 0 NOT used es a Medea (None of weed) O Used es s remdence (RwIstrillen fl) Page 3 or 6 W1441(340 11 MIPS Ay EFTA00098673 Registration No: 480216 Person Number: 7
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