498, end W-213. FE0042 Oat No. 14400O num 1096 (000$1 EFTA00233156 • K va' • O CORRECTED PAYER'S name, street address. °BY, IOW ZIP cone, end Nlephone no. 1 Rents Pjj,:wic 5..Q 1. c';: .1:13 COO t? at' V $ 2 Royalties Mx Income OMB No, 154G-O113 2003 Tenn 1009-MISC 4 rodeitInteme tox $ Mi