• FIVE STAR Date 1-8004odgenow re> 13 135 Purchaser Terf -gf y F. fes re r A, Co-Purchaser — 4$40 !/{ Driwr's Lc* 8irthdale4_/ 2- 5-13 West Ci 0 fo fil 33 ii.9 Street Address b/to Pa, Nfl2 QUARWES fi lsox• city 3117 hbm.4 s U < vt otgoA-5154-8 state Zip Home Phone 3 VC --77 '1 -16 </