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/ <br /> rorm To. 14. � �O _� �y <br /> • `/ :�nnu�nno� no..7:i�.��.�.. <br /> Nu......�.�...X..�"_..Y....�L:.i:��n`.?.T.:..... 9trrnl. <br /> . r�:ccrett.............�JZ�.t�../..?:....... tsn� <br /> TO TI([i SL'PF.RINTF.NbB\T OI' Tllh; Gl'IiRRTT 11'ATiiR CO\iPA\1': � <br /> . / � <br /> • ! he/r/euy nppiy for the uxe of x•atrr In nrcordnnce a•I[h the rnlns :�nd re�ulatlone o[ the R,vercltllVflter Compnn}•, nml requeet <br /> that n...l]!...inch tnp Le inecrtwl In the mnin at the pinr�� +ihm•e ctnlyd. - <br /> .� / <br /> Tli6�`_pinmbrr who w911 dn mc �cork is.. . .... � <br /> . ............ ............. .. ..... ........ <br /> � p\ \ ...... <br /> d................. <br /> Thr iT�cnrr of the pmmisrs Is............. /`/l��...�=:Y•�".J�;/�!h'!r� V.. <br /> ........ ......................\�\........ ............., <br /> r,.�' Tlir �Fcnt is..........................:�.. ........'�.��........................ ........................ ........... .............. <br /> Thct��nnnt le............................ .......�:�`:........................ ........................\,........ .............. <br /> � Thr �rnter rent should br rhnrged to............./.)�........................�.. . <br /> .. ..../ ....................... . <br /> S I Rned.����-!^.�!�.... !'{�fd.V�D�v�' ; <br /> ................. . ....... <br /> � l5r•� Othrr 91dc1. Appllc�nt. <br />