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(c) The name, title and address of the owner, partners or officers of the undersigned are: <br />NAME__ <br />TITLE <br />ADDRESS <br />U,n'i J1�Jfr9 <br />Eaa-3 _ <br />/v,/ Si— <br />(?E I Vei'fcp.a,.0 <br />,, ...—. <br />44AC itc. i�c.4)5-.. <br />7173 <br />(d) The names and address of all other persons, both natural and corporate, having a substantial <br />interest in the undersigned, and the nature of the interest are (if none, so state): <br />NAME <br />ADDRESS <br />NATURE OF INTEREST <br />(e) The names, addresses and trade classifications of all other building construction Contractors in <br />which the undersigned has a substantial interest are (if none, so state): <br />NAME <br />ADDRESS <br />TRADE CLASSIFICATION <br />Date: <br />oc <br />(Contractor) <br />By: <br />WARNING <br />Jim De Armond, President <br />U.S. Criminal Code, Section 1010, Title 18, U.S.C., provides in part: "Whoever, ... makes, passes, <br />utters, or publishes any statement, knowing the same to be false ... shall be fined not more than $5,000 <br />or imprisoned not more than two years, or both. <br />