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Co. 55 Water Street 10041 WRITER'S 1 NUMBER Cooper Union 4th Avenue & 8th Street New York, New Yor

s.) Mavis Lewis Recorder EFTA00187076 **PLEASE CHECK EACH WHEN COMPLETED** NAME ,c"? DATE OF EMPLOYMENT APPLICATION /c' Type "PCA" (one for Payrol l , one dupl icate SENT 416 RECD /if Bonding Appl ication /Or Stock Exchange Form Security Accounts form Fair Credit form Locator Card Benefit

Water Street N 10041 WRintS DIOCT DIAL NUMICR Cooper Union 4th Avenue & 8th Street New York, New Yor

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041 (212) 952-5000 WRITER'S DIRECT DIAL NUMBER Cooper Union 4th Avenue & 8th Street New York, New Yor

ecorder EFTA01700866 **PLEASE CHECK EACH WHEN COMPLETED** NAME t7 • DATE OF EMPLOYMENT S —Ar" 76 APPLICATION • /tits/ Type "PCA" (one for Payrol l , one dupl icate SENT 4/ to REC'D /t% Bonding Appl ication /i-"I Stock Exchange Form /ti Security Accounts form Fair Credit form Locator C