C,.,),---------------, rrlnh:J N:imdSic111:1,ur-t of Rc-ui,·io,e! Orfitit"r-; t _________________________ j------:-----::~ Dair: [ h.111,-~ lud.3). rc~·ieu·cd lhf' prapc-rt}' nfurac-c.l tom~-------------------------- 71.., 3/(f'~ ,f '{ Siiaature- of lam.arc 7~ n-- ~9 7-/J-l:i f-l, Upon rdtiil"iC of the 1111n