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F ortland Br:.nch
Federal Res rve B3nk of San Fr a nci sco
Fiscal -~ent of tne United S tate3
11-:: lephone :
Intervier1 :
r_d J.lt :
I inor :
1
~, 7:-ile :
}\:~!:t:-le :
----~; t,,)
t ·- \J c.
_ __
Cit : ". z ens n i p£;,:,-.oc__;;;___ _ "
.;...
In te of 1 ~t emr:: i. o United St:.tes = - - - -- - ·---·- .
T:·pe of B1..,.._ in ss :
ar ne shi·: :
P ropriet o:rsh i
F2rson L,t0rvier:l?d :
Add re.: s :
CorJ_)OT'......L-ion :
Indi vi. 1,.1:
P rincipal pro_err,_r involved and s cope of'
.Ac ti on
aker :
Portland Br anch
Federal Reserve Bank of San Francis~o
Fiscal Agent of the Un it ed States
T~lephone :
Int ervi ew :
v. ,
(City)
r~inor :
(S~e.t e )
D<.tte of last entry into United Stste s :
T y pe
J..dult :
-----
of Busine ss :
Partnershi::; :
Propriatorship :
.Ad Jress :
Corpor::::.tion :
Individual :
Telephone I ;_imber : _ _ _ _ _ _ _ _ _ _ _ _ __
Principal prop erty involved and sco_e
Action
t~ken : *
*Attach additional pages whe re nec e ssary.
Fortl n:l :!3:-anch
Federal Reserve ~2nk of San Francisco
Fiscal -~en of tLe United States
(D<:J. te)
T.:.lep1.one :
Interview:
..td~1J t:
_4.aaress :
r
·inor:
J.._7.;_ lP.
Fe1'.~:
:
10:
Cit:.zenship:
D: te of ~ .-t
0
)81"1t ·
l.~:pe
n
ntr~· iL i:;:) United. St -=:.t.cs ~---------- -·-
n•le_· _ ·e<:l
UY'::
L · cens e D ')W? :_. _ _ _ _
of B·ucincss:
LTtne 's ._.:_·, :
Propri~to:'3 __ i}J :
Cor:)or·~ tio
:
IndivL irl:
Principal prop
Action t,a.?:.en :*
r~y
Tele. hone
N~~bGr :
involved and scope of problen :
>
•
Portland Branc h
Federal Reserve Bank of San Franci sco
Fiscal Agent of the United States
(D<-.te)
T.::lephone :
Int;ervierJ :
~
;..dult :
r~inor :
/'
/
; ·:e.le :
Fern:...le:
Citizenship :
Dc.~te
of last e ntry into United St?tes = - - - - - - - -·-
0 .1ere.t ing under T r·c: 3sury Licens e now? :
T~pe
of Bilsine s s :
Partnershi ~ :
P
~oprietorship :
.A.d uress :
Corpor::..tion :
Individual :
Telephone l'J;J.mber :
Principal property involved and sco e of problem :
Action t .a ken :*
*Attach additional pages where nece Gary .
F ortlan Branc}
Feder al Reserve B~nk or San Francisco
Fiscal Agent of tLe United Staten
(D :i t e)
11 -=. l ephone :
In tervi::;w :
C-..f
•
Q
0
;._dult :
I Tjnor :
B
~,,~~ile :
:F01r.: .le :
Ci t .-:.zer..sh i p
Dr.tc of la:-t e r..J_ r:-' iL t
0 ' erc.t · n.
, ,..
United
SL~t.es
=--"'--
f6
T >pe of
B·llE i. s s :
urr.ne:!"'"'Li·J :
Propri e tc:r.::.h i
Cc>r·1)or:..... vi on :
Indivi wl :
Principal
pr0~)
Act i on t . . ker :
rt:· involved and. scope of" prob}c 1:
~
---~~-..;.;.-
Portland Br anch
Federal Reserve Bank of San Fr anci s co
Fiscal Aeent of the Uni ted States
T- lephon e :
Int e r vi 8VJ :
.rdl l t :
- - . . . . . - -- ----=::;::;,.;..___;:__.....:._._
(City)
~----·
----(~~at~)
'.'inor :
E;::le :
Yen::· le :
Cit.::. zensr ip :
Dhte of last ent ry in to United States :
---
o·n erat ing undP.:r ':!: [' C:J RSUry
T~.:pe
of B i..iE incj s s :
Par nershi ~ :
Proprietor ship :
Cor_l)Or'.ltion :
Individual :
Licens r~
n ow? :
Ferson. I JLt_jr vir:: i·.:\?·'l
Ad ci r eEs :
Princ ipal :property involved and sc ope of' -problem :
Act ion t.aken : *
*A.tt ac
additiona l pages w· .ere necessary.
:..d
t:.;. .: ;.; : ~-=-=::; ._ : :. . .: . _
F ortl 'tnd Branch
Federal Reserve Bank of San Fr anci sc o
Fiscal Aeent of tne United St a tes
(D~
t e)
-~1...: l ephone :
Name :
Int ervievJ :
(Print)
Aadress :
_t-<_d 1ll t
:
I ~inor
:
::c:
0
a
I\~::;. le :
Fen:: le :
-- \'.:
,·-·- - vf..t::J)
D:.te of
Q.ler. t.
a;t en1.1r:r ir. .,o United
St~tes;
----
-----
ng unde!' _ r·e.-...sury L · c nse nov;? :
0
T~·:pe of B·u sin ss:
Par ners _i' . . :
Pc3 ·son
7
ate:rvie··:ed : _____________
P ...·oprietorsh ·
.Address :
Cori)or:..:. ti on :
Indi vL t ..al:
Telephone IJ mb 13 r :
Principal properu.
1_
involved and scope of proble~ :
Act i on tar.: n: *
*.htt ""•c h
Cit~zensn i p =~ -
..
r
d . t ion· 1
a
s --1: e_·~ ne ess ry .
Portl::md Br 2.nch
Federal Reserve Bank of San Franc i sco
Fiscal Aeent of the United Statei3
tI1
•
r_r . . : lep '1or; e :
Int e r,~i t:::i·,r:
r . . '.).l t :
'.'.in.or :
.. ';':le :
J<:'u.: le
Aadress :
(C i ty)
-----c~:~:.t
~
C~r-izenshi:-o ~
;; )·- - -
Dc.tte of last entry in to Un ited States :
- - ------ - ·- - --- - -- - ·- - -
o ·oerat ing un:lp r
T~.:pe
~
r·e 2su-ry
Lic e ns ;~
of B\.i.E im; s s :
P ar nersh i~J :
P ·011ri 2torship :
Cor'!-)OT'...t ti on:
Indiv·:l ual :
n ow? :
Ad ·.reE s :
Principal property involved and
v
:;#/ ~"'
r-/I/ / . {
//· Je r/J;/v.1w--rn
Action t!lken : *
}hll'.i
*Attac
ad1itional pages where necessary .
,:} b y :
0
Portland Branch
F ede r al Reserve Bank or San Fr a n ciGCO
Fiscal .A,eent of the United States
Interview :
;..d ult : ,._,,,
I~inor :
Male :
Fem·. le : --
Citizensh i p :
(,., i ty)
D<-.tte of last e.r.·r..,r ir2to United
St:~tes
:_ _ _ _ _
Q.1erating un er ':' ·easury L · cense now? : _ _ _ _ _ _ _ ___ _ _ _ _ _ _ _ _ _ __
T~::pe
of Bi.lEL ... ss :
Partnerst.i:::
P opriato:-ship :
Corpor:;.tion:
Ind· vi ial:
Ad ress :
----;--Telephone IJ:.tmber :
Pr i n cipal prop rt.r involved and sco_e of" probler.i :
Ac ti on t?ken:
*Att~ch
dd·t·onal p
es ,he ·e ne essary .
~.
-;----·~--..........~~-,..._---~
Portland Br an ch
Fede r al Rese r ve Bank of San Fr a n c i sco
Fiscal Agent of the Un i t ed States
(DL<te)
'l :lephone :
Interview :
;.~dul
Andress :
.
/
( strtertmd Number)
t :
I~inor :
'·- - - - - -
i
~a le :
Fem:-: le :
(C i ty)
Citizenship : _ _ _ __
-- --:-----"-----
( S~at e )
D<Jte of last entry into United Ststes :
- - - - - --- ----
----
o-. )erat ing under T r·easury Licens e now? :
Type of
~usiness :
Partnershi~~ :
Proprietorsr_ip :
Cor:)or:. ti on :
Indi vi-l ual :
.Adu ress :
Pr i n cipal property i nvolved and s c ope of problem :
I
Act i on ta.Ken : *
*Attach additional pages where necessary.
.<::
Portland Branch
Federal Reserve Bank of San Francisco
Fiscal Agent of' the United States
T ~ lepho n e;
Interview :
.tdult:
r··inor :
~1~2 le
:
Fem.~:le :
Citizenship: ...c:&--- -, - -
D~~tc
of last entry
0 >erating unrln !' T
T~:pe
i~to
·~asur: ·
United States :
License
of B"(i.E inc.,ss:
Partner·.: hi_. . :
IlC>"W? : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Ferson L1 2rvierh:d :
Address :
P ·· opriet o:rsn ip:
Cor~)or~ti on:
Indlvi:lual:
Principal prop rt
- - --- - -
Telephone N·Jmb er :---".}.JCLQ:
. . :...-...:_ ___.~
;._,.,;:--f__;____,_ __
involved and
of problem :
Acti on t.aken: *
*~tt
ch
d~it'on·
p~
es ?ne re ne
.~ssary .
(/)
•
TION
~ ~~i '~
P ortland Br anch
Federal Re s erve B~n1c or San Francisco
Fiscal Agent ot the Un ited States
/
ljf
t::J
•
T;: le phone :
Intervi ew:
.f.~d ul t
:
'.'.inor :
'1a le :
F ern.: :l e :
Citizens h ip : _ _ _ __
{C i ty)
D~te
-
·- .
of last entry into Un i ted
St~t e s :
-----
0·: 1e rat ing unde r T r'easury Lic ens e n ow? = - - - - - - - - - - - - - - -- - - - Type of Busine ss :
P artners h i ~ :
Propri etorsh ip :
Corpor::tion :
Individ ual :
Te lep hon e N;_@b e r : _____________
Principal property invol ved and sco: e of problem :
Act i on tfiken : *
*Attach ad d i t ionB. l p age s vvhere ne e ssary .
.
0
Portland Branch
F eder a l Reserve
FiscGl
.A.ee~t
B~nK of San Fra nci s co
of the Tnit ed State s
(Dt:t t e)
T.:: l ephone :
Int e r vi evr :
;._dul t:
P.Odress :
~
Tinor :
r,~ale :
Fen~:~le :
Sitizen sh i :!:J :
IJ:.te of
~a.
t enL
,r ir
to United St·-:.tes :
------ ----
0 )erct · ng un'ier : r·e·1sur: LicPr se now?: ________ _
r:l' pe of
l"'t:r.son ·
Bl<E iness :
P · r ne rs ri. · ~: :
P . .:oprieto:rshi
Cor.:.Jor)tion :
Indi vi al :
Jt ·
a:rvie··:l?'~ :
v
P r ine ipal pro:)ert
r
A.cicre~~ :
Telephom~ ~J .• mbor :
invo] Ye
and scope of pr·ob le. :
Act i on taken :=-:
tf;;;in le
·~tt~ch "~ition
1 pa es 7Le
0
Il
essrry .
- - - ·-·-·- - - - -
Fortl ·md Br an ch
Federal Ress rve 3ant:: of San Franc i. 0co
Fi s c3.l -.\ee n t of ti1e Un it ed States
lephor:.e :
Ir tervic. ·:; :
·.~1-~
Name :
Andress :
(S t1·e 8t
~m ~
------. :u.r1ber '
--
·- - ---·
//? __2L.3-~-·--_____________ _
I r>,_. t · )
( Gi _, y)
DLte of
:1_3.~-t
T>pe of
B·ltE
i
e n CI I'Y ir. t ~) Jni ted
S t;:~
-s : ________,_____ ·---
~-.. hlt :
:·inor :
~
C ~ t ~zens . i.:?~--- ----
___________ ______ _
'.lr_, c: ~3 :
P& r"'.:'ne :'::.~r: i.~~ :
p ~~oprL-;t OT Ship :
-------- - -·--------·
,..,OT)O:''....!..tion :
Ind i viJ. :1al :
Prine iriu..l
·pro~ierty
Te::... e. hcrH:'. I'·Lmb ·.-: r: ____ _ _
invo lved
an~l
scope cf ·probJ or.i :
Action t .a~en : *
~-*b..tta
'h
ad d itiono.l
lVJ. ~e s
-;. m e.re r ec t:.:- ss bry .
F ortl nd Branch
Federal Reserve B~nk of San Franc i sco
Fiscal ~ent of tne ·nited States
(Di:t t e)
T .:le phone :
Intervie1t1 :
I\farne :
(Print)
;._dul t :
.· adress :
I rinor :
(St re e
'illd iIUI11b er)
Male :
:Fem:· le :
Cit :.zenshi9:
D:.te of 13.st
entr~r
Q.)er t. n · under -;: "
T~:pe
i::.to United St ... tes ;
.:lSU
----
L · cenc::e now? :
of
BL<.S iness:
Par-+-ners .. i::.:
P:::oprieto:rs ip :
C:ir-:.or'..2. ti on:
.Address :
Indlvi ual:
P rincipal
pro~ert
Telephone N _~I'.J.b r :
r
involved and scope of problem :
Act i on talren :*
·' 1.tt ch
v.
1 · t io
1 pa es
··1: ere
n
essary .
F ortland Branch
Federal Re s erve Bank of San Fra nci s co
Fiscal .Aeent of the United States
(D(:. te)
T ..-::.lephone :
Interviev1 :
~
0
(j)
_dult :
Aadress :
: ~inor :
____(_S_t_r-·e- e-_, t-ffiia Nu111ber_)________
Yale :
Few: le :
::;itizens h i ~ ;
_ _ __
(Cit.y)
D:.i. te of las t entry in to United St 3t.e s
~
---- -- ---------- ------- ------------
O.lere.t ing unrier ':1 •e 3sury License
Il ') W? :
T:.: pe of B·L;.s in e ss:
Person
Par
I~terv i e~e~ :
nershi~ ~ :
Proprietorship :
Corpor:.;.tion :
IndivBual :
Ad<lrsss :
Telephone ILmb e r :
rrincipal property involved and scope of problem :
Action taken : *
";{3n 1le·"
*httach additional pages
·1-ihere necessary .
by : _____________
Portl nd Bnrnc
Federal Reserve B~nK or San FranciJCO
Fiscal .:\.r;en"t of t.he United States
Name=
T ~lephone:
fv
I
~
m
•
Intervi!.~w :
.ri.d ult : ,__.,,
1
:inor :
Fem: · ] e :
------
<tc
of~
.-t
en: r~:
(~ ~r~t ,·•
)- - - - -
iLto lJnitecl St:?.t. s: ________·----·-
O )e.rn.t ·
T~pe
of
Tele_
Principal pra1.1·rt.
inrolved an
hon~
(p . .
.h.tt &
·a.1·t·ona
I
I -
N.lrr.b e r :
scope of probler.t:
/iu-~---·~
Action
cit izens.li n:
·- --·--------
Portland Branch
Federal Reserve B3nk of San Francisco
Fiscal A.gent of tne United Stat es
.
.
~
(Dh t e)
T~ lepho ne :
IEtervie.n ;
Name :
;._cl .ll t :
: -inor :
; ,~r~ le :
F ein:-. le :
1
A.a.dress :
C~tizens rt ip:
(Ci y)
D<-.c te of last ent ry into Uni t8d
T~pe
of
St :~to s
: ____________ - - - - - - - - - - - -
B~sin e ss :
Partnerst.i~: :
?
~
o]ri e torship :
Cor~)or:...:.tion :
Indi ril11al :
Principal
pro~erty
Tele~
hon e I·L.mb i3 I' :
invoJved and scope of problJm :
Action t.aken :*
:bn-He:: bJ :
*Attach ad.di t ional pages v,rhere necesse.ry .
-~--~~---~-~
tz>
Portland Branch
Federal Reserve Bank ot San Francisco
Fiscal Aeent of tne United States
(Date)
11 s.lephone:
Name: A
Interview:
J.~d ult :
V"
r:inor : /
rv~ale:
Fem: .le:
~
/)
~
Citizenship:(__,__~~r
,. t ·:>)
( -\JC
""·,
Dute of last en r; in o United Ststes:
----
Type of Busi ess:
Partners _· :: :
Proprieto:rship:
Corpor::>..tion:
.Ad ress :
Indi vi ' :::11:
Telephone N·.tmber : _ _ _ _ _ _ _ _ _ _ _ __
Principal prop rty involved and scope of problem :
Act i on · .aker:: *
*Att ch
dd "t "o a
p
e s 1her
na esrary .
F ortland Branch
Federal Reserve Bank of San Francisco
Fiscal Aeent of the United St ates
T .::lephone :
Intervie1-~r :
;._dul t :
1
-inor:
Jv'.a le :
Yernc le :
Ci L.zenship ;-·-- - - -
D:.! te of last entry into United St:::.t e s ; - - - - ··- -- - --
- - - - - - -··- - - - - -
Q.)era ting under T r-eas ury Licens e now? :
T :.:pe of B·l:.s ine s s :
Par
nershi ~: :
P ... opri e torship:
Ad u r eE s :
Corpor:::.tion :
Individual :
Te ::!..ephone N_'.mb e r: ___{J'-----?;:1:....-..-=--='----''--·- --1
Principal pro?erty involved and scope cf problem :
Actfon taken :*
*htte.ch addi t ion9.l pages rvhe re ne essary .
F ortland Branch
Federal Reserve B~nk of Sa~ Fr a nci sco
Fisc3l ..\eent of the United S tates
T..:le:phone :
Iri. t er vi ev1 :
;._thlt :
! :inor :
Tv'8le :
Fe1n_:-1e :
e
(Street
Citizensh i p :
C:t ._,)
( c_., :.""'-""'
"'
(Si"ty)
D:1te of la. t en.,r:.: ir.to United St ~tes = - - -----·Q , )er~t
· ng un
·e s
~......
y L · csns(
n:Jv;'? : _ __
F~rson
I.~ervie~ed :
Address :
Cor1)or:.....t.io :
lnd.i.vi ue:l:
Principal prop rt.
Telephone I hmber : ___~--------1
involved
scope of problen :
~ nd
Action taken : ·
*il.ttach
io
1 p
es / er
n
es~ary .
Portland Branch
Federal Reserve Bank of San Francisco
Fiscal Agent of the United States
'l slephone:
Name:_::?3i
Intervi8''U :
;.~dult : ~
r·~inor :
. -~21e :
--~'
{City)
Citizens h ip:
Lic.i. te of last entry ir.:to United st~tes =--------~- Q·; rnr!3.t ing unde r '"!: r·e rrsury Lic e ns e no u? :
1
·-- -
T ype of Busin e ss :
Partnershi~~:
Propri etorship :
Corpor:::.tion :
Individual :
Principal prop erty involved and
Action t.aken :
v
Fe1r..:.l8: ,,.,,,-
.A.d u r e ss :
sco ~ e
of probleCT :
*
*Attach add itional pages where nec e ssa ry .
- ---- --
@FedFRASER