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Name of Issuer
Address of Principal Executive Office
Place of Incorporation
Exact Title & Class of Security
Par or Stated Value of the Security
No of shares Outstanding as of the
end of the Issuers Most Recent Fiscal
Year
7. Name and Address of the Transfer
Agent
8. Nature of Issuers Business
9. Name of Products Offered
10. Nature & Extent of the Issuers
Facilities
11. Names of the CEO and Members of
the Board of Directors
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Profit and Loss Retained Earnings
Statement for the Precedent Fiscal
2. Latest
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(if applicable)
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