e. S15071 UDC 3 yeah. 51212 Canorar38.349r Car work: Wu, enlarrn•bnatraye Pahlacorariswirro won cat I 866 797.28.2.6 ACCOUNT SUMMARY Ata.nt Hanby: 1360 5111 1911 PPorma &Pp= ^.43$4 Fitymont Soda -SO3 64 Purthattop .:629882 Cutalkhava•• 9)00 &Carte Thorehrs SO GC ream enamel 502 mwea

Yes I No (Approval valid 10 months from examination date) Palient Narrar. , C,..-isti r skin , -3-cc-R--e_v £ D " nature: I>Ds ELI- -76 r Hanby: 3 I Se:- os-m Institution: / MCC NEW YORK Date: 7- 26 -1 9. Signature Block/Stamp: 9 DS PCF Presented by P8400 et en a ter MCC New York