w, PLLC, 3. TYPE OF EMPLOYMENT 4. DATE OF BIRTH 6. MAR/TAL STATUS O. DATE MIDDAY OF ACQDENT 2004-2006 7. TIME (AM. OR PM.) Various/Multiple • Lamar FIcwitim 8. BASIS OF CLAIM (Ste's In detail the known fads end circu damage. Injury. or death. Identifying persons and property Invohed, the place of °cairn/n