de, and telephone no. JEGE, INC. C/O GEORGE V. DELSON & ASSOCIATES 110 EAST 59TH STREET, 28TH FL. NEW YORK, NY 10022 1 Rents $ $ $ RECIPIENTS Identilleadon number ftltge4relankEti 2 Royalties 3 Ouw McOme MD No. 1545.0115 MO4 Fam 1099-MISC 4 Feint Worm tax veltheld Miscellaneous Income PAYER'S F

ss (As shown on nyistration CV: ea) Amen PO BOX 2218 SANDUSKY Pa" OHIO re 44871-2218 Caret UNITED STATES 3. For FAA Use Only 4. Type 6. Unit Identilleadon - Reese Mention tall Mae Model Serial No. 7 in AIRFRAME PAYTMONeetts./teONAWe (As described M Item / show) me244 POWERPLANT O nPROPELLE