of which he o she is a victim, I will notify USCIS. I. Signature of Certifying Official (sign in ink) 4 2. Date of Signature (miniddiyyyy) 3. Daytime Telephone Number 4. Fax Number Form 1.918 Supplement a 04/24/2019 Page 4 g 5 A A EFTA00155348 Part 7. Additional Information 1 If you need extra space to comp

Date Receipt Remarks 26 Federal Plaza City or Town (ILSPI VP rode Lank -A Apt. Ste. Flr. Number 0 0 El State ZIP Code NY New York 6. Daytime Telephone Number 7. Fax Number 102711 Form 1-914. Supplement B Edition 12/C0/21 Page I EFTA00156636 Part 2. Agency Information (continued) 8. Agency Type El

0010 3.g. Postal Code O Respondent (ICE, CBP) 3.h. Country Information About Applicant, Petitioner, United States Requestor, or Respondent 4. Daytime Telephone Number 5.a. hand) \aim: (tam Name) S. 5.b. Given Name (First Name) Fax Number Middle Name L 6. Addresc 6. Name of Company or Organization Of aPPi

IN: b. Corporation name: ■ FTB 5860 (REV 05.2014) 03 PAGE 3 - I 586000121343 • EFTA00613375 Part C - Signature. Print Name Title (required) Daytime Telephone Number ) Signature Date Fax X ) Mail within the next 30 days: • A complete copy of your California business entity tax return. • Proof of payment,

if purchaser is a Corporation or Partnership, List Corporate Officers or partners rchaser's Permanent Address' 6100 Red Hook Quarters 93 rchaser's Daytime Telephone Number. Purchasers Drivers License 6 and State: Purchasers Passport or %sae. Name of Seeing Dealer. Gilman Yacht Sales, Inc. Address of Sailing Deale

nd every instruction and question on the form, as well as the answer to each question. Signature Print Your Name Date Firm Name (if applicable) Daytime Telephone Number (Area Code and Number) Address Fax Number (Area Code and Number) E-Mail Address IIIIIIIIIII11111111111111 1111111 1 1111 1 Form 1-539 (10/07!11)

Describe the nature of your disability and/or impairment and the accommodation you are requesting.) Part 4. Information to Contact You 1. 3. 5. Daytime Telephone Number 2. 4. Work Telephone Number (if any) Evening Telephone Number Mobile Telephone Number (if any) Email Address (if any) Part 5. Information Abou

Date Date Reloc Rec'd Date Date Receipt Remarks 26 Federal Plaza City or Town New York IMPS ZIP Co* Loging2 Apt. Ste. Flr. State NY 6. Daytime Telephone Number 7. Fax Number Number ZIP Code 10278 Form 1-914. Supplement B Edition 12/02/21 Page EFTA01653122 Part 2. Agency Information (continued) 8. A