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Fortn Nn. 14. �-.,� � : . / <br /> � / h} illratinn \n./.. G / <br /> — (�7 '/ /......... � <br /> - � Nn.... .. . �(, Y <br /> •% ................�� 1 .._.^. ...........SVML ' <br /> � <br /> TO Tldls 9l'1`I:IiIS9'IC\I)1:\T OF TtIIi " ; ..�...iscrtclL......... ��'�l�u �� �� <br /> I.\ I.I2IST'1' \1',\TIsIi CO\IPA\1': ............ .................t•�.� <br /> 4 he r.b}• :�Pplg for Ihe nse uf �c:�ter in nrrm�dnuc�r u�ith th�� rulrs mid rr7:iilations of iho Idrrrr�t 1Cnt�r Cumpnm•. nn�l requrat <br /> � Omt. a`.���. inrh I:�p Ln ina�rl��d In Hir��?+�tu n� Ihc pinq}'ab/�orr, stated. <br /> 7'h�� mrn � �'4 ?�!U-��C./��C/F4 C.QC� . <br /> i <br /> TLn 1 nmbor �cho �cfli dn �np �coiqc Iv..... ' <br /> . ...... ........ . <br /> .. ............................... . <br /> ....... . .. <br /> ✓ <br /> ............ <br /> er ut Lhc pn•mince �s............✓'�\ ��l�q!l.�� Z �'iu� � ' <br /> �'.... .. . ...� ................. <br /> . ........ ....................... <br /> ' � � � ..... .. <br /> , '-,/ / l"� <br /> Thr �iRen� Is... . ............. ..........�l.lottalc �(.�/�<J11tt� ' <br /> ._ • ... �....... ....�.......... <br /> . ............................ <br /> .... ............. <br /> T:io trnant is...................... "� <br /> .................. ... <br /> ...... . ....... ......................... <br /> . ..... ...... <br /> /'_ ............. <br /> . TA� �e;�tnr rrnt vhnnld br rhnrl;rd to......... { �/ ����w'✓ <br /> � . ........... ... . • <br /> � ...............li....... <br /> ...... FIRn�d....V.!i� .. ... ��?7/1.tf�l "l.�l/ <br /> _ . <br /> ISrn plh�r Riilai � �j /'.. <br /> ....... ........... .... .... <br /> . � �(/ ���t��Y-tTA/1� �TX�"' APpllcnnt. <br /> .n�_._.'___.__ . <br />