, • OilEitia2 Mate. ZIP Coor.'and telephone no. Cr.paaptai;y: yn1c. 1' Rents OMB No. 1646-0119 2003 rem 1099.MISC et7 (*3,71 Y. pteirly. 3 Royaltlas 3 Other Income $ 4 Federal Income lax validvitd S State Copy or Extra File Copy PAYERS Frideml idonalcallon number 66 -05G711 g RECIPIENT'S