r male &ea sates or 15,0(0 or intro of ecratimar products to a buyer (reelable) for ogee t* 0 0 Substitute meats h Ike ni dieends or Knot 11 10 Crop Insurance proceeds $ 3 Excoss golden parachute 14 Gross pomade paid to PaY11111.1 en attorney $ ts State le vAthhced ii 17 State/Payees ;tato ma For Pr

of $6,000 of man of comma products to a Wye( ((edge() for rude * $ 16 Stale tax SIMS $ 6 &bra* vowels le fan d dhldmds or Interest ' • 10 Crop Insurance proceeds 1S Egan adds' persolue pasinerits 14 OnSee POSOCOOS COW to an attorney 11 $ 17 StateiPayces state nO. • For Privacy Act and Paperwo

: '‘..er $1 000 . 00 6 lAtdeal ad Noah ore mites ..tttle-Tijakte"-tI1/41,W1.44 S 8 Suembuit menu in 5„ d mass tr nom ic.a. ATINtatt,_,” $ 10 Crop Insurance proceeds P.O. BOX 7077 City. Mate. end VP code BOCA RATON 3 Meant melba 5aMitna0 53514WaWadoVNiArag: 9 Payer made dried sales et solace « mor

° compensation $ $ 6 Medcal ant bars ure ppm S 0 StbsI0/la prirreas In Eats ml GIANNI or freest 15 Fo7n 099-M7Se 9 Per: made arm salts of 10 Crop Insurance proceeds 15,000 or inn of ConSIIMAr ts to a Nye' Spent} for roads ti• tj toss golden porachtd Copy C For Payer or State Copy For Privacy Act