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0 (c) The name, title and address of the owner, partners or officers of the0 unders _igned are: <br />NAME TITLE ADDRESS <br />(d) The names and address of all other persons, both natural and corporate, having a substantial interest <br />in the undersigned, and the nature of the interest are (if none, so state): <br />F-NAME ADDRESS NATURE OF INTEREST <br />(e) The names, addresses and trade classifications of all other building construction Contractors in which <br />the undersigned has a substantial interest are (if none, so state): <br />0 <br />NAME I ADDRESS I TRADE CLASSIFICATION _jj <br />(Subcontractor) <br />(Signature) <br />(Typed Name and Title) <br />WARNING <br />U.S. Criminal Code, Section 1010, Title 18, U.S.C., provides in part: "Whoever, makes, passes, utters, <br />or publishes any statement, knowing the same to be false ... shall be fined not more than $5,000 or imprisoned <br />not more than two years, or both. <br />