E/ 7 , O f ig 06 PLACE / i L/L/e..2462lk- L i FL- U i A- -r-r—csia, . L M 3e. ca. /Ca e n GL_ SERVED ON (NAME I b3 b6 b7' ir TITLE cr c.Lai STATEMENT OF SERVICE FEES TRAVEL SERVICES TOTAL DECLARATION OF SERVICE I declare under penalty of perjury undo the laws of the United States of