n for an indivilusits), any, who, directly or tnirectly. through any contact arrangement tinders* rel&tonship. Or Otherwise owns 20% or mete Of the eQaiy interests of the Iegalwaly fated above. & Fist Name 6. Last Name 7. Ml 9. Data of Birth 9. Address 10. City 111. Stan 12. ZIP/Postal Code 13