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EFTA01338175
rgin Islands Wage and Tax Statement Copy 1 -For vl Bureau of 'Memel Revenue or Copy D-Fot Empleger 0 Sacred Nally Moosoc 4 &ell semidry twain O. Medlars Vot ilgerg 2 66 rt '193.31 it ltd ▪ aortal fanbor 22222 OM No. 1445.4001 • EMPLOY& mourstato orbit OM 66—O567418 I mono. toot alle tampon:0m 2
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