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91-0211060_990EOR_201005.html
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<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<title></title>
<meta http-equiv="Content-Type" content="text/html;charset=utf-8" />
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<div class='ocr_page' id='page_1' title='image "tif/002.tif"; bbox 0 0 3392 4403'>
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<p class='ocr_par' dir='ltr' id='par_1' title="bbox 631 2540 2777 2735"><span class='ocr_line' id='line_1' title="bbox 661 2540 2777 2626"><span class='ocr_word' id='word_1' title="bbox 661 2540 717 2626">2S</span> <span class='ocr_word' id='word_3' title="bbox 840 2579 1005 2616"><strong>check</strong></span> <span class='ocr_word' id='word_5' title="bbox 1049 2579 1181 2618"><strong>her:</strong></span> <span class='ocr_word' id='word_7' title="bbox 1227 2579 1284 2618"><strong>1!</strong></span> <span class='ocr_word' id='word_9' title="bbox 1329 2578 1421 2614"><strong>the</strong></span> <span class='ocr_word' id='word_11' title="bbox 1465 2576 1869 2622"><strong>arulnltutian</strong></span> <span class='ocr_word' id='word_13' title="bbox 1917 2578 1972 2612"><strong>1:</strong></span> <span class='ocr_word' id='word_15' title="bbox 2017 2578 2111 2614"><strong>not</strong></span> <span class='ocr_word' id='word_17' title="bbox 2155 2575 2427 2616"><strong>ruquirad</strong></span> <span class='ocr_word' id='word_19' title="bbox 2472 2576 2532 2612"><strong>to</strong></span> <span class='ocr_word' id='word_21' title="bbox 2573 2576 2777 2614"><strong>attach</strong></span> </span>
<span class='ocr_line' id='line_2' title="bbox 631 2631 2705 2678"><span class='ocr_word' id='word_23' title="bbox 631 2636 901 2675"><strong>Schedule</strong></span> <span class='ocr_word' id='word_25' title="bbox 947 2638 999 2675"><strong>I.</strong></span> <span class='ocr_word' id='word_27' title="bbox 1049 2638 1145 2674"><strong>You</strong></span> <span class='ocr_word' id='word_29' title="bbox 1189 2634 1319 2675"><strong>must</strong></span> <span class='ocr_word' id='word_31' title="bbox 1361 2635 1491 2675"><strong>also</strong></span> <span class='ocr_word' id='word_33' title="bbox 1535 2635 1663 2678"><strong>sisn</strong></span> <span class='ocr_word' id='word_35' title="bbox 1704 2631 1801 2674"><strong>the</strong></span> <span class='ocr_word' id='word_37' title="bbox 1845 2632 2217 2675"><strong>dccznration</strong></span> <span class='ocr_word' id='word_39' title="bbox 2260 2632 2320 2672"><strong>at</strong></span> <span class='ocr_word' id='word_41' title="bbox 2368 2632 2463 2672"><strong>the</strong></span> <span class='ocr_word' id='word_43' title="bbox 2505 2635 2600 2674"><strong>tad</strong></span> <span class='ocr_word' id='word_45' title="bbox 2647 2632 2705 2670"><strong>of</strong></span> </span>
<span class='ocr_line' id='line_3' title="bbox 632 2694 1033 2735"><span class='ocr_word' id='word_47' title="bbox 632 2694 761 2734"><strong>this</strong></span> <span class='ocr_word' id='word_49' title="bbox 804 2694 1033 2735"><strong>littlr.</strong></span> </span>
</p>
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</body>
</html>
<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<title></title>
<meta http-equiv="Content-Type" content="text/html;charset=utf-8" />
<meta name='ocr-system' content='tesseract'/>
</head>
<body>
<div class='ocr_page' id='page_1' title='image "tif/003.tif"; bbox 0 0 3392 4405'>
<div class='ocr_carea' id='block_1_1' title="bbox 204 1202 342 1240">
<p class='ocr_par' dir='ltr' id='par_1' title="bbox 205 1204 341 1238"><span class='ocr_line' id='line_1' title="bbox 205 1204 341 1238"><span class='ocr_word' id='word_2' title="bbox 205 1204 341 1238"><strong>111.0161</strong></span> </span>
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<div class='ocr_carea' id='block_2_2' title="bbox 1892 230 3009 384">
<p class='ocr_par' dir='ltr' id='par_2' title="bbox 1896 238 3005 361"><span class='ocr_line' id='line_2' title="bbox 2639 238 3005 288"><span class='ocr_word' id='word_4' title="bbox 2639 238 3005 288"><strong>0425830663</strong></span> </span>
<span class='ocr_line' id='line_3' title="bbox 1896 304 3005 361"><span class='ocr_word' id='word_6' title="bbox 1896 318 2024 360"><strong>Mar.</strong></span> <span class='ocr_word' id='word_8' title="bbox 2083 312 2176 361"><strong>18.</strong></span> <span class='ocr_word' id='word_10' title="bbox 2228 309 2367 356"><strong>2011</strong></span> <span class='ocr_word' id='word_12' title="bbox 2449 305 2552 352"><strong>LTR</strong></span> <span class='ocr_word' id='word_14' title="bbox 2600 305 2783 350"><strong>2695c</strong></span> <span class='ocr_word' id='word_16' title="bbox 2901 305 2924 342"><strong>0</strong></span> <span class='ocr_word' id='word_18' title="bbox 2977 304 3005 342"><strong>R</strong></span> </span>
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<div class='ocr_carea' id='block_3_3' title="bbox 1899 339 3010 515">
<p class='ocr_par' dir='ltr' id='par_3' title="bbox 1900 370 3008 477"><span class='ocr_line' id='line_4' title="bbox 1900 370 2708 426"><span class='ocr_word' id='word_20' title="bbox 1900 378 2255 426"><strong>91-0211030</strong></span> <span class='ocr_word' id='word_22' title="bbox 2380 370 2708 420"><strong>201005-67</strong></span> </span>
<span class='ocr_line' id='line_5' title="bbox 2720 430 3008 477"><span class='ocr_word' id='word_24' title="bbox 2720 430 3008 477"><strong>00018558</strong></span> </span>
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<div class='ocr_carea' id='block_4_4' title="bbox 461 548 1747 712">
<p class='ocr_par' dir='ltr' id='par_4' title="bbox 464 577 1744 702"><span class='ocr_line' id='line_6' title="bbox 464 577 1744 638"><span class='ocr_word' id='word_26' title="bbox 464 590 775 638"><strong>FRATERNAL</strong></span> <span class='ocr_word' id='word_28' title="bbox 823 586 991 633"><strong>ORDER</strong></span> <span class='ocr_word' id='word_30' title="bbox 1039 589 1099 628"><strong>OF</strong></span> <span class='ocr_word' id='word_32' title="bbox 1143 581 1348 629"><strong>EAGLES</strong></span> <span class='ocr_word' id='word_34' title="bbox 1388 580 1557 626"><strong>AERIE</strong></span> <span class='ocr_word' id='word_36' title="bbox 1609 577 1744 624"><strong>lfifio</strong></span> </span>
<span class='ocr_line' id='line_7' title="bbox 465 656 1525 702"><span class='ocr_word' id='word_38' title="bbox 465 661 529 702"><strong>PO</strong></span> <span class='ocr_word' id='word_40' title="bbox 571 657 672 702"><strong>BOX</strong></span> <span class='ocr_word' id='word_42' title="bbox 715 656 815 700"><strong>519</strong></span> <span class='ocr_word' id='word_44' title="bbox 1519 662 1525 669"><strong><em>'</em></strong></span> </span>
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<div class='ocr_carea' id='block_5_5' title="bbox 463 702 993 779">
<p class='ocr_par' dir='ltr' id='par_5' title="bbox 464 717 992 768"><span class='ocr_line' id='line_8' title="bbox 464 717 992 768"><span class='ocr_word' id='word_46' title="bbox 464 721 600 768"><strong>ELHA</strong></span> <span class='ocr_word' id='word_48' title="bbox 677 720 743 762"><strong>WA</strong></span> <span class='ocr_word' id='word_50' title="bbox 825 717 992 761"><strong>9l5fi1</strong></span> </span>
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<div class='ocr_carea' id='block_6_6' title="bbox 1328 1081 1718 1141">
<p class='ocr_par' dir='ltr' id='par_6' title="bbox 1329 1088 1717 1137"><span class='ocr_line' id='line_9' title="bbox 1329 1088 1717 1137"><span class='ocr_word' id='word_52' title="bbox 1329 1088 1717 1137"><strong>DECLARATION</strong></span> </span>
</p>
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<div class='ocr_carea' id='block_7_7' title="bbox 611 1153 2661 1603">
<p class='ocr_par' dir='ltr' id='par_7' title="bbox 619 1200 2653 1585"><span class='ocr_line' id='line_10' title="bbox 619 1200 2387 1274"><span class='ocr_word' id='word_54' title="bbox 619 1230 787 1274"><strong>Undur</strong></span> <span class='ocr_word' id='word_56' title="bbox 835 1224 1148 1273"><strong>annuities</strong></span> <span class='ocr_word' id='word_58' title="bbox 1192 1220 1253 1264"><strong>of</strong></span> <span class='ocr_word' id='word_60' title="bbox 1300 1217 1567 1262"><strong>nnrjurvo</strong></span> <span class='ocr_word' id='word_62' title="bbox 1621 1213 1643 1254"><strong>I</strong></span> <span class='ocr_word' id='word_64' title="bbox 1691 1212 1940 1254"><strong>doclaro</strong></span> <span class='ocr_word' id='word_66' title="bbox 1985 1205 2123 1250"><strong>that</strong></span> <span class='ocr_word' id='word_68' title="bbox 2176 1201 2197 1246"><strong>I</strong></span> <span class='ocr_word' id='word_70' title="bbox 2248 1200 2387 1244"><strong>have</strong></span> </span>
<span class='ocr_line' id='line_11' title="bbox 621 1258 2651 1337"><span class='ocr_word' id='word_72' title="bbox 621 1292 900 1337"><strong>uxnminuu</strong></span> <span class='ocr_word' id='word_74' title="bbox 944 1289 1044 1333"><strong>thu</strong></span> <span class='ocr_word' id='word_76' title="bbox 1091 1285 1292 1330"><strong>rnturn</strong></span> <span class='ocr_word' id='word_78' title="bbox 1337 1276 1684 1326"><strong>idontifiud</strong></span> <span class='ocr_word' id='word_80' title="bbox 1735 1276 1797 1318"><strong>In</strong></span> <span class='ocr_word' id='word_82' title="bbox 1843 1273 1980 1314"><strong>this</strong></span> <span class='ocr_word' id='word_84' title="bbox 2027 1269 2271 1314"><strong>luttur.</strong></span> <span class='ocr_word' id='word_86' title="bbox 2328 1258 2651 1308"><strong>includinn</strong></span> </span>
<span class='ocr_line' id='line_12' title="bbox 621 1326 2532 1401"><span class='ocr_word' id='word_88' title="bbox 621 1365 719 1401"><strong>any</strong></span> <span class='ocr_word' id='word_90' title="bbox 765 1348 1185 1398"><strong>Iccanpnnyinn</strong></span> <span class='ocr_word' id='word_92' title="bbox 1232 1342 1537 1390"><strong>scnadulcs</strong></span> <span class='ocr_word' id='word_94' title="bbox 1581 1340 1687 1384"><strong>Ifld</strong></span> <span class='ocr_word' id='word_96' title="bbox 1735 1334 2120 1381"><strong>ntntonunts.</strong></span> <span class='ocr_word' id='word_98' title="bbox 2172 1329 2280 1372"><strong>and</strong></span> <span class='ocr_word' id='word_100' title="bbox 2327 1328 2391 1368"><strong>to</strong></span> <span class='ocr_word' id='word_102' title="bbox 2437 1326 2532 1366"><strong>tho</strong></span> </span>
<span class='ocr_line' id='line_13' title="bbox 624 1374 2653 1461"><span class='ocr_word' id='word_104' title="bbox 624 1418 757 1461"><strong>hunt</strong></span> <span class='ocr_word' id='word_106' title="bbox 803 1416 863 1454"><strong>nf</strong></span> <span class='ocr_word' id='word_108' title="bbox 909 1422 976 1457"><strong>nu</strong></span> <span class='ocr_word' id='word_110' title="bbox 1017 1406 1328 1449"><strong>knouludyl</strong></span> <span class='ocr_word' id='word_112' title="bbox 1368 1404 1469 1442"><strong>and</strong></span> <span class='ocr_word' id='word_114' title="bbox 1512 1398 1756 1440"><strong>a.1£ur.</strong></span> <span class='ocr_word' id='word_116' title="bbox 1808 1394 1868 1436"><strong>it</strong></span> <span class='ocr_word' id='word_118' title="bbox 1919 1394 1983 1432"><strong>1:</strong></span> <span class='ocr_word' id='word_120' title="bbox 2027 1396 2197 1433"><strong>truo.</strong></span> <span class='ocr_word' id='word_122' title="bbox 2252 1384 2499 1428"><strong>curroct</strong></span> <span class='ocr_word' id='word_124' title="bbox 2544 1374 2653 1422"><strong>and</strong></span> </span>
<span class='ocr_line' id='line_14' title="bbox 628 1442 2652 1521"><span class='ocr_word' id='word_126' title="bbox 628 1473 929 1521"><strong>convicts.</strong></span> <span class='ocr_word' id='word_128' title="bbox 988 1472 1009 1513"><strong>I</strong></span> <span class='ocr_word' id='word_130' title="bbox 1056 1464 1399 1514"><strong>undnrctand</strong></span> <span class='ocr_word' id='word_132' title="bbox 1441 1460 1576 1504"><strong>that</strong></span> <span class='ocr_word' id='word_134' title="bbox 1623 1454 1763 1500"><strong>this</strong></span> <span class='ocr_word' id='word_136' title="bbox 1809 1446 2205 1494"><strong>duellrution</strong></span> <span class='ocr_word' id='word_138' title="bbox 2251 1442 2393 1489"><strong>H111</strong></span> <span class='ocr_word' id='word_140' title="bbox 2437 1445 2652 1486"><strong>income</strong></span> </span>
<span class='ocr_line' id='line_15' title="bbox 625 1524 1755 1585"><span class='ocr_word' id='word_142' title="bbox 625 1548 653 1580"><strong>I</strong></span> <span class='ocr_word' id='word_144' title="bbox 697 1534 1012 1585"><strong>nornlnont</strong></span> <span class='ocr_word' id='word_146' title="bbox 1057 1532 1187 1577"><strong>part</strong></span> <span class='ocr_word' id='word_148' title="bbox 1235 1528 1297 1570"><strong>af</strong></span> <span class='ocr_word' id='word_150' title="bbox 1340 1525 1469 1568"><strong>that</strong></span> <span class='ocr_word' id='word_152' title="bbox 1517 1524 1755 1564"><strong>ruturn.</strong></span> </span>
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<div class='ocr_carea' id='block_8_8' title="bbox 613 1607 1901 1850">
<p class='ocr_par' dir='ltr' id='par_8' title="bbox 635 1660 1899 1836"><span class='ocr_line' id='line_16' title="bbox 635 1660 1899 1836"><span class='ocr_word' id='word_154' title="bbox 635 1785 943 1836"><strong>Signlturl</strong></span> <span class='ocr_word' id='word_156' title="bbox 989 1781 1053 1825"><strong>0!</strong></span> <span class='ocr_word' id='word_158' title="bbox 1101 1660 1335 1836"><strong>offiggr</strong></span> <span class='ocr_word' id='word_160' title="bbox 1376 1784 1439 1816"><strong>ur</strong></span> <span class='ocr_word' id='word_162' title="bbox 1487 1742 1733 1812"><strong>tru§t;t</strong></span> <span class='ocr_word' id='word_164' title="bbox 1833 1737 1899 1744"><strong>*_</strong></span> </span>
</p>
</div>
<div class='ocr_carea' id='block_9_9' title="bbox 661 1864 1341 2027">
<p class='ocr_par' dir='ltr' id='par_9' title="bbox 663 1884 1340 2005"><span class='ocr_line' id='line_17' title="bbox 663 1884 1129 1953"><span class='ocr_word' id='word_166' title="bbox 663 1884 1129 1953"><strong>5cr£1.‘-I}?!-£>’</strong></span> </span>
<span class='ocr_line' id='line_18' title="bbox 1069 1950 1340 2005"><span class='ocr_word' id='word_168' title="bbox 1069 1950 1088 1986"><strong><em>’</em></strong></span> <span class='ocr_word' id='word_170' title="bbox 1172 1958 1340 2005"><strong>T1t1|</strong></span> </span>
</p>
</div>
<div class='ocr_carea' id='block_10_10' title="bbox 2369 1658 2712 1800">
<p class='ocr_par' dir='ltr' id='par_10' title="bbox 2371 1658 2707 1797"><span class='ocr_line' id='line_19' title="bbox 2371 1658 2707 1732"><span class='ocr_word' id='word_172' title="bbox 2371 1658 2707 1732"><strong>5-.2/J/</strong></span> </span>
<span class='ocr_line' id='line_20' title="bbox 2408 1753 2541 1797"><span class='ocr_word' id='word_174' title="bbox 2408 1753 2541 1797"><strong>Data</strong></span> </span>
</p>
</div>
</div>
</body>
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