AT DATE OF THIS REPORT SI COO F. HIGHEST TOTAL PAO-IN CAPITAL STOCK DURING REPORTING PERIOD $1.000 SECTION 4 • comrinAnoN OF TAX A. AT RATE OF SI-SO PER THOUSAND (PLEASE ROUND DOWN TO THE NEAREST THOUSAND) ON HIGHEST TOTAL PAID-N CAPITAL STOCK AS REPORTED ON LE* 31 ABOVE 3150.00 S. TAX DUE OA OR $