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Portland Branch
Federal Reserve Bank ot San Franc~sco
Fiscal Agent of the United S ates

1

J.

Name:

-lephone:

Intervie~v:

_ adress:

C ~t:zeLs n i_p:

T ~ pe

of Bilsine ss:
Partner st i""' :
Propriet

ship:

Te lep hone Numb e r:
~~~~~~~~~~~~~

property

I

I

I

I

I
I

I
I

I

I

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I
I
I

I

I

I
I

I

and scope of problem:

I

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)....

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u

I

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I

_L

./I

;;. 0

Action
I

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H· n

*Attach ad.di t ional pa es rmere necessary .

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Portland Branch
Federal Reserve Bank of San Franc~sco
Fiscal Agent of the United States

s/
:·inor :

0
D<te of ~ast ent ry int o United St 2te s:

.. ~:-:lP

;

F e:::

l~:

c.:. Lze1:shL :

----

Type of Bileiness:
Pa:r"tne rshi~J :

P J.~opri e torship:
Corpor::.:.tion:
In di vi'.l ual :

A.d u ress:
Te2-cphone Humber = - - - - - - - - - - - - --

of problem :

Act ion t.aken: *

·n
*Att"'cr ad itional pa-es where ne e ssary .

Portland Branch
Federal Reserve Bank o! San

Franc~sco

Fiscal Agent of the United States
(D:ite)
T ~lephone:

Int -~rvi e.w:
~:..- 1.1~ t:

Aadress:
~-~--,--~---~~~~~~--,.---.....,....-=----. ?

(Street

qn 4

Number)

r ~inor:
.\~P..1-

:

Fen::·le:

CitizeLship:

Dc.tte of last entry into United

T~pe

St,~tes :

----

of Business:
Partnersti~J:

Proprietorship:
Corpor:ition:

Ad :recs :

Ind.vi ual:

Telephone IJun.ber : _ _ _ _ _ _ _ _ _ _ _ __

Principal property involved and scope of problem:

Action tp.ken:*

iano .. e

*Attach ad.J.itional pages where necessary

Portland Branch
Federal Reserve Bank ot San Franc~sco
Fiscal Agent of the United States
(D:ite)
T~lephone:

Int t-:rvi e.~·.;:

F <:: m:· le:

Citizens,

ip:~~~~-

I

Dc.tte of last entry into United St::>t8s: _ _--=----=O·o erat ing under ~ r·easury Licensr.. n o w ? : - - - - - - - - - - - - - - . . - - - - - - - T~pe

of Business:
Partnershi~:

P1,oprietorship:
Corpor:J.tion:

.A.dJreEs:

Individual:

Telephone IJ;..unber : _ _ _ _ _ _ _ _ _ _ _ __

Principal property involved and sco.e of problem:

Action t.aken:*

Hendl
*Attach additional pages where necessary,

LC
Portland Branch
Federal Reserve Bank of San Franc~sco
Fiscal .Azent of the United States

r:i

Name:

-lep!-1one :

lr:t·-~rYiew:
--~--~--~----------~~~----~-

r_:hlt

A.adress:

~---~----~----~----~--__..._----------~

Nu.I'1ber)

~

!

'inor :

.1.:n le:

Fem: le:
C.:. t .:zens.'1i D:

(City)
Dc.Lte of

last entry into United St ate s: _ _ __

O·rnrat ing un Pr T r·e. 11sury Lic ensr- n JV:? :
T>pe of B·u.siness:
Partne _ shi::::;:
Proprietorship:
Corpor:.:.tion:
Individual;

------~~~--~---------:r---~~----~

Ad .::rsEs :

Principal property involved and scope of problem :

Action t.aken: *

*Attach ad1 itional pages whe re necessary,

c

c

Port land Branch

Federal Reserve Bank ot San F?anc~s~o
Fiscal Agent of the United StatBs
(Dtite)
j_'~lephone:

InterviBw:
..... -=iul t:

I:inor:
.. ~r, le:

Fe:r.:' le:
C~t:zens~iP :_£_~~~~~~

Dhte of

ast entry into United St Pte s:

o·nerat ing under T r•easury Licensr" now?:

__

__:,....

__

----~-----~----,....=~-~----~

Type of Business:
Partne rsbi~ :

Proprietorship:

Address:

Corpor'.ltion:
Ind'vidual:

Telephone J.\Jumbe r

Principal property involved and scope of problem:

Action t.aken:*

*Attach additional pages whe re necessary.

=-------------

Portland Branch
Federal Reserve Bank of San Francisco
Fiscal Aeent of the United States
(D:~te)

T-lephone:
Ir. t•-;rvie~·; :

1~ .;. t _:_

Lhte of last entry into United Stqtes:
o-oe rat ing undP.r

r~ r'd3SU!'y

z en s : i .r :

----

Licensr.. n-.JW':':
--~---~-~---

T>pe of B"LiS iness:
Partnershi-:_::
ProprietorshiV:
Corpor-ition:
Indivi'.iual:

Principal property involved and

Tele. hone ,J.1mber : _ _ _ _ _ _ _ _ _ _ _ _ __

sco~e

of problem :

Action t.aken:*

*Attach ad it ional pages \·(.ere neces3ary,

Portland Branr.:

Federal Reserve Bank of San Francisco
Fiscal Aeent of the United States

'.L1 ~ lephm-;.e:

In t~;rvif,-:J:
'i. t:
! 'i1wr :

.l"'..

,,

x:r.:le :
re:. le:
r:~t~zersi1i:' :

DcAte of :ast er..try ir!to United St at.cs : _ _ __
o ~ ,e.rat

ing under Tr· .... .sury
0

Licensr~

now?:

T>:pe of B·ll.siness:

Partnersti:J:
P "oprietorship:
Corpor:..:.tion:
lnd.:.vL ual:

.A.d're:=s:
Tele. hcne IJ.Jmber:

Principal property involved an1 scooe of Jroblem :

Action t,aken:*

*A.ttacn ado..itional pages wnere necessary.

Portland Branch
Federal Reserve Bank or San Francisco
Fiscal -~ent of the United States

.t1 -lep hor~e :

Ir. t er\·:.. t7>..:J :

~

·inor :
p:

,.7r•

F':>.: ·le :

- -( (~ :;. t _, )- - - -

D2te of _ast entry into United Stat8s:
o·oerat ing url'ii::r· T r·e !1SU:ry Licer. . sr~ nov:?:
Type of

C ~t:::.zer.s ai~ :

---~~-----~-------~-:'--~

Busin~ss:

Partn e.rsti~J:

P ~oprietorship:

Ad'rsss:

Corpor:...:.tion:
IndiviJual:

Tela. hone

Principal property involved and scope of

Action tp.ken:*

*.Attacn ad . . itional pages v(.ere necessary .

N·1mb:.~ r:

______________

c
Portl~md

Tl

Branch

Federal Reserve Bank o! San Francisco
Fiscal Aeent of the United States
'.l ~le phone:

Ir: t

~rvit?.:·J:

...:-'...d 1 1lt:

Aadress:

-----~---~~-~-~-------

~ 'inor :
•. -:---:1~ :

Ft;H'.' l~:

·----

(City)

c_;_t~zer:s.'1i...:

( :_:: uf:t ···)

Dc.:.te of last entry into United Stetes:
-~---

o·Derat ing unrl 0
T~·pe

T

r;:1 f'P.A.SU!'y

Licer.sr-:

Il .)ii;' . :

-------·

F 2r.sc

of B·1.lsim. ss:

:"t~rviei·,:t. ~

Partnersf.i~:

. ,..· ·~~~

----

.rl.d •rec-s:

P ... oprietorship:

Corpor'..!.tion:
Indi vi - ual:

)
Act ion t.a1rnn: *

*Attach ad..:.i t ional pages

r(

ere necessary.

Cl L CO T

L

Portl3.nd Branch
Federal Reserve Bank o! San Francisco
Fiscal Ae;ent of the United States
(D .• t~)
_ne:

T~leph

_1.1.adress:

G.:.t~ze1:s .n iI';

I

Dhte of :ast entry into United Stqtes:

One rat :ng un1er·
T~·9e

~ r· c~qsury

Licer..s . ~

n Jv:'::

------

of B-1.i.Ein< ,ss:
~J artnersh i~~:

Proprietorship:
Corpor2tion:
Ind· vi1 u.al:
Principal property involved

an~

scope of p

-

Action t.aken:*

*Attach ad..1.itional pages w' .ere ne essary.

0

l

0

Portland Branc~
Federal Reserve Bank of San Franci ..:> co
Fiscal Agent of the United Sta.tea
(D: ,te)
T ~lep hone :
Ir~

t ~: rvi e.;·J :
..:•..... 'll t:
~·inor :
~.~r;.J.e :

Feu:· le:

D~.te

of ::.ast entry int o United

o~ierating

unfr:r

Tr·(:f.)su:~:;

St ,~te s: _ _ _ _

Li cenS·-

Il )V; . :

L ________________ _

----

T>pe of B\.tS innss:
Par nersti=J:
p ...~oprietorship:

.Ad

Corpor:..:."tion:
Indi vLual :

Te::..ephone

re~:... :
IJ...tmb~ r

Princ ipal property involved an1 scors of proble. :

Act ion -c.aken: *

*Atta h ad .Ai t ional pages w .e re ne

ss·1ry.

: _______________

Portland Branch
Federal Reserve Bank of San Fr&ncisco
Fiscal Agent of the United States

c51~y
(D:,te)
'l ~le phone:

Int-:.n'ie;·J:
_..._ ll t:

/v- )
(Street

!fil

1 Number)

r/

C9
Dc .. te of . . . ast entry into United
uni Pr Tr· .<mu y Li
T>pe of Bl.~sim, ss:
Partne_ shi:~:
?.roprietorship:
Corpor ..it ion:
Indi virlual:

St ;-:. t:..~s :_____l_t_~
_O_ I

e rs •~

n JK .

:

----

Tele hone .'1 :. unber: _ _ _ _ _ _ _ _ _ _ _ __

Principa.l property involved and scope of p. ·obler.1:
I

Action tp.ken:*

*.Attac. ad1it ional pages r( .ere necessary,

Portland Branch
Federal Reserve Bank ot San Francisco
Fiscal Agent of the United States
(D~,te)
T~lephor~e:
lEt·~rvie'.-;:
. e-~ 1 L t:

Andress:

~

~-----~~~--~-..,-·~------

(Street Ml~ Nur!lber)

- - - ( r- \J.,.._~0)-•
I

Lhte of _ast entry into United States:

01)erating unde~ T r·eRsury Licens•T~:pe

of Bi.tS inr:=:ss:
Partner st i:J:
P 1~opriet or ship:

Il)\i"'':'

·inor :

":r:l - :
Fem· le:
C~Lzens!li

I

-----

=-------------+--+---------

.AdJI'e~ s:

Corpor:.:.tion:
lndi viiual:

Telephone Nu.nbc::r:
-----~-~------

Principal property

olved and scope

Action t.aKen:*

*Attach adr.....i t ional pa es where necess ry.

Portland Branch

Federal Reserve Bank of San Francisco
Fiscal Agent of the United States
(D:.te)

T... lephone:
Interv2.eo;·1:

Aadress;

h

I

.t"'• .

----~-----~~--~---,.~-~~-~~

(Street

(

811~

Nunber)

<

(City)
D~te

of _ast entry into United Stat es :

----

One rat .:.ng un,.lP r 'T r·C:!asury Licensr_, now?:
~----~-~

Type of

B~sinsss:

Partne_ sh i:~:
Proprietorship:

Ad,rssc:

Corpor'.ition:
Individual:
Principal property involved and sco_e of problem:

Act ion t.aken:

*

*Attac: adr.... itional pages w· ere necessary.

t:

~

~·inor:

,\'"le:
Fe:r:· le:
c~ :zens,1ip:

Portland Branch
Federal Reserve Bank of San Francisco
Fiscal Agent of the United States

·~, ~

Name:

(D:.te)
lephone:

In.t~;rv :..e.~·; :

-~-hlt:

Aadress:

~'i1

~-~--~~~~~----=---~---~-

!ffi 1

NuI11ber)

or :

,.'.: l.:. :
Fe u:.· le :
c,;.t~ze1~s n i~ :

Dc-te of :ast entry into United St~tes:

----

I

0 )erat ing un'lP-:r- T r·E->.r.su:ry Licensr.., n 'Jv,·. :
T~:pe

of Bi.i.S i n e s s :

Partnersti:.,:
P ...,opri et orshi p:
Corpor::ition:
lndi vi'.lual:

.A.d..;. re f: s :

Principal property involved and scof e of probloCT :

Action t.aken:*

*Attac. ad1itional pages wnere necessary.

- - - - - --- ·---

Portland Branch
Federal Reserve Bank ot San Francisco
Fiscal Aeent of the United States
(D:ite)
.i.'~lephone :

Ir t ~rvi c;·:; :
.id

I

Aadress:

t:

.. ~.'"; l.::> :
}"· · le :

.)
D&te of last entry into United

St~t~s:
Il ·JW?:

T>pe of

Person ....... terviei·.-·?i:

im,ss:

----

shi~:

Proprietorship:

C.:. t=:. zer:sn it' :

----

o·nerat ing undc r T r•e[rnury Li ens(.>
B·Li.E

.::..

'. inor :
( Stniet ,qn'.1 NU111ber;

Partne_

l

.AddreG=:::

Corpor~tion:

Indivi:iual:
Principal property involved and scope of

Action tp.ken:*

*Atta.ch adG.i t ional pages rrnere necessary,

--------

Portland Branch
Federal Reserve Bank of San FranciGcro
Fiscal Agent of the United States
(D~.te)

'i

~ lepho1~e:

Ir. t .-;r\ri 8<.',' :

Aadress:

r_>i.lt :

I
~~~~~~-~~~~~---,-~~"----~-'=~~

(Street

fill.~

: "inor :

KuI'lber;

Ferr~:

le:

,i tizens.:ir.';

Dhte of

ast entry into United States:

O:rnrat ing under-

~

r·easury Licens<"'

----

Il·)V;. :
~~~~~~~~~~~:.--~--

Type of Business:
Partnersti .,..J:
P

~oprietorship:

.A.d 1 reEs:

Cor1Jor'..!tion:

Individual:
Principal property involved and

sco~e

of problem :

Action tp.ken:*

1bn-jle'

*Attach adc.itional pages where necessary,

Port land Bran ch
Federal Reserve Bank or San Franci:sco
Fiscal Agent of the United States
(D:1te)
T~lephone:

Ir:tervie':J:

__, .llt:

~:..

! .inor :

.. ~.. le:

~

//I
C~tizens.-:i .. ;j__
tu-v

Fe;•.: le:

(Ci.-iy)

Dc.:.te of last entry into United

T~p~

of

(:u~~T--(Q

Stqt ~ s: - - - - -I (p

'1-

------

B~sinAss:

Partnersti]:
Proprietor ship:
Corpor2tion:
Ind· vU.ual:

Ad

re~:=:

Telephone m1mb8 r : _ _ _ _ _ _ _ _ _ _ _ __

Principal property involved and scope of'

Action tfiken:*

*Attach adrli t ional pages where nece 3sary •

Portland Branch
Fed~ral

Reserve Bank o! San F~anei.s~o
Fiscal Agent of the United States
(D:.te)
T~lephone :

Ir.t•3nri8',';:
n.1:11t:

Aadress:

!"inor :
i~re_li.:> :

F em·· 112:
(:~t..:.zens.:.ip;

Dhte of last entry into United Stat.es:

- - - - - -I-

Type of Business:
P· rtnershi:.,:
?

l~oprietorship:

Cor:por:J.tion:
Ind.vi ual:

Principal property involved and sco_ e of p.roblen:

Action t.aken:

*

*Attech adctitional pagss w· ere nece sary,

---.. . . . =--

Portland Branch
Federal Reserve Bank ot San Francisco
Fiscal Aeent of the United States
(D~1 te)
T-lephone:
In tervie1·;:

r_d 11 t:

Aadress:

~

·inor :
7

"~ ale:

Fe:clt::
C:.:. L.zeLshi n

Dc.tte of last entry into United St qt es :
01>erating under _·r·e3sury Licensr-: nJv:.:
T>pe of

B°Li.S

---- ~

~~~~~~~~~~~-~---~-+-~~~~~

iness:

Partnershi~ :

Proprietorship:
Corpor:::.tion:
Ind'vidual:

Act ion t,aken:

=

*

*Att ac: adui t iom1l pages \'( ere ne e ssary,

Portland

Bran~h

Federal Reserve Bank or San Francisco
Fiscal Aeent of the United States
(D:.te)
T~lephone:

lr.. ter1.·ic.-:::
..:-'.. '11- t:
~

rinor:

.::-.Ji:=>:
J"e;r: le:
r,..:. t .:zens: i

0 1rnrat ing undPy·
T~ ·pe

~

r·t-'RSU y Lie ens•,., n0vi?:

of B·uc: in . . ss:
Par ne:rsti _~:
Proprietorship:
Corpor::.:.tion:
lndiviiual:

-------

.Ad ·rise: s:

Principal property involved and scone of problem:

Action t.aken:*

*Att acr. adi:i.i t ional pages w ere necessary.

~:

Portland Branch
Federal Reserve Bank of San Francisco
Fiscal Aeent of the United States
(D·ite)
T ~lep hone :

In tervit'?.W :
;.~ d 1 L t:

Aadress:

(Street

~1

!·inor :
7
Ple :
Fen:· le:

Nul!lber)

,

c _;,_ t izens~i-::.':

D~te

of :ast entry into United States:

o·n erat ::..ng under

Type of

rr r·eRsury

B~sinLss:

Licensr. . n )V,"?

----

: _ _ _ _ _ _ _ _ _ _ _~

Fe:rsor L1. ·ervie":: :·1 :

Partn e rshi~J :

?roprietorship:
Corpor'.ltion:
Individual:

-------

.Ad 1re.!:s :

Te lephcne N·1Inber : ________________

Princ ipal property involved and scope of probleCT :

Action t.aken:*

@
*Attach adr..:.i t ional pa~es ii ere necessary•

Portland Branch
Federal Reserve Bank of San Franci~co
Fiscal Agent of the United States
(D:,te)
1

r~ ~lephone:

Name:

Intervie~·J:

~~~--~~~~-----~~--------~-~~

(Print)

~'"'->Lt:

Aadress:

~ ~inor :

Fe.1: le:

c.:. L.zens'.

ip:

(City)
Dhte of _ast entry into Jnited

St~tes:

----I

0 )erat ing under T r·cjasu::--y LicPr;_sr_, nmv?:
-~~~-~-----~----~-~~-~~

T>pe of

Bi.'i.E

inr-::;ss:

Partn ersti~J:

Proprietorship:

.AdjreE s :

Corpor~tion:

rele hone m.mber:

Indivilual:

--~~------~~~~

Principal property involved an1 scope of problem:

Action t.aken: *

tbn-:1

*Attacr.. adu.i t ional pages

r(

ere necess' ry.

'1 b

c
Portland' Branch
Federal Reserve Bank of San Franci3co
Fiscal Agent of the Dnited States
(D,.te)
~2 ~le phone:

Name:

I1:.b~rvie·.v:

.rd l t:
I 'ineor:
.\''.:le:
:Fe:r:: le:

Andress:
(Street An d NtlJTlber :.
)

1-: ~ t ~ ze1~ s.n i .~P: --·-

---

Dhte of

a t ent ry into United Stqt ~ s:

----

I~

o~)erat ing undP..r 'T r·e!rnury Licensr~ Il)V;?:

T:·pe of faisinoss:

P artne:rst. i=:-;:
oprietorship:
Corpor::.:.tion:
Indivi'.l al;

?

Principal property involved and sco_e of problem:

Action t.aken:

*

*Attach ad . . i t ional pages

i"l

.e e necessary.

I

------

C 'J

ON

Portland Branch

Federal Reserve Bank of San Franc~sco
Fiscal Agent of the United Stat es
(D~1te)

'l ~le phone :
111.t·~n~ie-.•· :

~.:._)

Andress:

llt:

. 'inor :
:.~:;.le :

F :::r: le:
1

I
One rating un er rr1 r·easury
T~:pe

of

Licensr~

n )Vi?: _ _ _ _ _ _ _ _ _ __

B·LiS iness:

Partnersti~J:

Proprietorship:
Corpor:.:.tion:

Indi vU.ual:

Te::._ephone N mbcr : ______________

Action t.aken:*

*Attac

ad ri it ional pa es n ere necessary .

c ,, c

Portland Branch
Federal Reserve Bank of San Francisco
Fiscal Agent of tne United States

ST

(D:1te}
1-lephone:

Ir t

"'!r\ri8~'J:

.t'_dult:
; ·inor :
·'·Tr.:.le:

Aadress:

Feil: le:

I
'Sc..te of

ast entry into Uni teci St st.es:

Q.Jerat ing un Pr

~:.:.t:zeLs .. i~:

----

~ r·eRSu!'y Licer.s - n0w. :
~~-~-~~-~----------

T~.:pe

of

B\.tS

iness:

Partnershi:-J:

Proprietorship:
Corpor::.:.tion:
Indivi ·ual :

~

.Ad

're~ s:

Tele hone N..u;.ber:

involved and sco·e of

Action t.aken: *

*Attach adaitional pa es rf ere ne essa.:'y.

------

LC

T

Portland Branch
Federal Reserve Bank of San Franc~sco
Fiscal Agent of the United States
(D~,te}

Nrune:

T-lephone:
In t -: r 'T ~ e w :

~---~---~~--~-__,..---~--~~

.l"'-

Aadress:

-----+-_.-~--------:--------

,qn c1

NUP1ber:

De.tte of last entry into United

T~,- pe

'.ll t:

' inor:
\·-:le:
F e n~: le:
..,,.:. .:.zens:-ii
1

of B\.i.S iness:
Partner sh i:-.. :
P oprietorship:
Corpor:.:.ti on:
Indi viiual:

St~~tes: ------I ~

Ad • reEs:

Telephone

y involved and sco_e of

Action tp.ken;*

*Attac: ad':iit ional pages \'/ 1ere necessary•

~\fumber

: _____________

c

Portland Branch
Federal Reserve Bank of San Francisco
Fiscal Agent of the United States

1 -lephone :
InterYierJ:

(Print)
t :
'inor :

~.....d ~12-

A.a

1

. :;l>=> :

Fe:cle:
Ci L.zensnil' :

Dhte of last entry into United St~tes: _ _ _:;;:;___..;:i_ _

T~:pe

of B\.i.S iness:
Partnershi::, :
Proprietorship:

CorporJ.tion:
Indivi ual:

.Ad"rsss:

Telephone IJ'..unber : _ _ _ _ _ _ _ _ _ _ _ __

Principal propert

Action t!iken:*

1lan · 1e;- b/ : _ _ _ _ _ __..._ _

*Attac.n additional pages w· ere

ecessary.

C L

Portl3.nd Branch
Federal Reserve Bank o! San Franci..::;co
Fisc3.l Agent of the United StatsB

(D~.te)

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Ir: te;rv _:_ t:,~·;:

:_ ... 1J.lt:
, inor:
.(r1le:
Ferr· le:

Dc...te of last entry into United St:::.tes:

T>:pe of B"\.i.Ein<.ss:
Partner st i::,:
Proprietorship:
Corp or:.:. ti on :
Indivi:lual:

----

I~

..Ad:re2s:

Telephone

J·..Lmb-=:r:

Principa~ty involved and score of problen :

Action t.aken:*

*Attach adei.itional pages rf ere re e ss'ry.

---·---------

Portl:md Branch
Federal Reserve Bank of San Franci3co
Fiscal Aeent of the United States

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t:

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---

Fe.r: le:
c.:. t :-:.zenshL :
(City)

Lc.,te of .::..ast entry into United Ste.tes : ______

T>pe of B·usin8ss:
Par nersr: i:=.:
P .roprietorshi-p:
Cor1)or'.:.!. "ti on:
Indivi:iual:

t/
.Ad'reEs:

Telephone IJ....Lm r.;;r : _ _ _ _ _ _ _ _ _ _ _ _ __

involved and

Action t.aken:*

*Attach

adr~itional

_!_ __

pa es \»(,ere ne ess'lrY •

IL

Portland Branch
Federal Reserve Bank of San Francioco
Fiscal Aeent of the United Stats:3

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~

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D~te

of la-t entry in,o Jnited Stqtes:

T~:pe

of B"1.'lEin:.-ss :

Par

- - - - -I

------ - -

-

ner!:ti~J:

? opric:torship :
Cor:_)or-::.ti on:

Indivi:lual:
scope cf problem :

Act ion t.aken: *

*Attac. additional pages w· ere ne

~ssary .

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Portland Branc:i
Federal Reserve Bank of San Francisco
Fiscal Agent Df the United States

(D:.te}
.:;:' _lep hone :

In t·-~rview ;
r'. ' ,

Andress:

ll t :

,,....,

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Fe·r.· le :
Cit~zenst~i:':

DL e of last entry into United Stgtes:
0

'ere.t:ng

unrl<~·

?r·msu!'y L'cens-_, n::>·:.:

----------

T>:pe of BuEiness:

Par

nersl~

i:-J:

P.coprietorship:

.A.d • r -·~ s:

Cor~or~tion:

Ind'vi:lual:
Principal property involved and sco s of problem :

Action t.aken:*

*Attach adr. . . i t ional pages

r(

ere necessary.

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Portl:md Branch
Federal Reserve Bank of San Francisco
Fiscal Aeent of the United States

(D:,te)

Name:

----~--~----------__.,.__...._

_____

M

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IG t erv.:. ff'.:;:

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Fe·r:· le:
, i Lzen.sh i:;i:

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~ast

entry ir.to United

0-:)erat ing undPr

~ r'<:~asury

St !~t.8 S

Licensr~

T>pe of B·li.S inAss:
Par nersti~::.:
P .roprietorship:
Corpor:..:.tion:
Indivi:lual:

..:.::;:__L ______ ---· ______

:_ _ _

n:::>w. : _________

.Ad~rec.~:

Telephone IT-1nber:

------------------~

Princ·pal

Act ion t.aken: *

.

*Atta.ch ad..1.i t ional pages

i'/

ere necessary.

~n·..

e·•

Portland Branch
Federal Reserve Bank or San Francisco
Fiscal Aeent of the United Stat es

T-lephoLe :
Ir.tcrvic:':; :
r.:3.u2 t:

Aadress:

! ·inor :
l.~rllµ :

Feu: le :
G~t2.zensnip :

D<.tte of

~ast

entry into United States:

0 rnrat ing undP:r T r·(-.! RSu:ry

Licensr~

----

I

noV1;. :
~---~-------~---~---~

Type of Business:

Fersor

~a~

ervie··,:·:-'"!. :
~----~~-----~-

Partnersti~:

P . oprietorship:
Corp or:. . ti on :
Indivi ual:

involved and sco_e of probleCT :

Action tp.ken:*

*Attach ad...l.it i onal pages r( ere necess

y,