re of the equity Interests of the legtlentily 5. Fine Nemo 6. Last Name ; 7. Mi. 1 8. Date of Birth 1 1. Address 11 10. City 11. State 112 MP/Postai Coda , I it Country I 14. SSW it f S. Parsons, tkn-U.S. Pram) i 16. Identification /lum %ev. Poe ron Mnierc e caw, 'mar bar f n yok ist, ! 156 St