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I~S7HL'CTIO~? FOR TIIE COAIPLF.TIOS OF .1 P'
<br />nFPLICATIO>~ FOR n\~,tIR !'O LL UT10~~ EcU$S10.~' FF.RNIT
<br />i r: Gao~• in; inslrvnions fm tS: completion of Oc Affiic elion fer Emisroo F: r:nil er- lirtcd, Inmrd. ee] nunhc r-d t5e um: a rte :fpLuble s:; de.v of 6: loan r.: ~~r
<br />r:~:r s:d:. II a ac:linn does nel eppl)'. =~ri1: 'i\~A'~ DO \'OT LE_\~ E DI.A\F:.
<br />A~n~: tili:+(or-mlion subrn:d as psr. rf LSis p:m~I Si Fiiu:irner'_sll'_::s[:n=need hp Ne DividCnn psn of prnrssin,., Lhis penrJi =iil 6: rnnGd: r.d<f:n 1. C.: pvh~e
<br />t t':n con Gd: -ae1 Ire~lmcm is rou m:d in actin; All rv:b slvLrisO \P_R he (0 d<srly mad rd 'COUFIDEhTL\L• end (:) eraoa] is s!t~ nlt !::::d ta•:I: pr
<br />e~.i:d'CO::FIDE~-TIAL L~F02V ATi0\"so tcmr. sysims sx:~c:cu~r.La~ CenGdcnliJ{q~is pnr..arN)'if l6c rt!ns<rf rs:S icfor-urian o~.uid r. r_'r.mr-crcnJ:
<br />Lns!.ec,+¢: In N: eppf ac:. I( con52:nG.e:a+' is rgonLC, L.e Cniicr. =;!I ctllfr rru of ils dsision md. if L; qid, sllo~+' G-.: fer }es Ie p-en edl:aar~l ni!: c.c
<br />(:.~.;,%-y Oc ee:C fer cev.r~d:.:9:!i:+'. h,u.:nl,:nn5d:r.(ul~:•r-::ate'+~!: r.: r.ac p:rmilpmeum; nr..:. UrGcr no arvmr~n:escan e:viuimvCo he h:!$ccnL,:n;'ul.
<br />I FF. ti\pT 1SiLGD TO: Lis: i:c n:ae o!L.e perun(c .tore^.:ion, pannenhip, utrt u+ian, Iedi.idvil o~'neq rr,r•:em:-ul sp•n.j:o =hcml`.-;;:rul
<br />is so b: nau;d ee'_ =h,. w,li d: r..`cr. b: r. spcndbl: fr: i'.: c, :..^-~~oo rf the u+u re.
<br />7e. AGENT FOR SER}ICE:Tc{sn the pcwnar wm.?r.•!c;sa. ^~; rn.ibL•lar dl pemis e:liens; vhis:um:nGlcd.isp 6c Ce!cndo $::n,n of$~:e. If O:n
<br />u ro 'Apcm for S: ri; c,-='r: 'F.A -
<br />7 h Fcd:nl Tax ID \c-Scr n en r-w~ • i~5 D:psr.m: cl cf R:•: r.a:.
<br />= GE\'ER,11. K:1TLRF.OF BL'SI\T„C1: Lis: Lhc 6minusea,in lccv pe:ku.uwrnill,fur..i:un msnvbrlvnL tort..: ridprir.:inp, Lr. r.-s]in~.ec J. Nu,
<br />16: 0: SV ndsrd I:.]vnriel Ch uiSr ei.on ($ LC.) for C.is h;: c(.`+slna• utivily.
<br />5., AIR MLLLTIO\'SO LRCE DESC RI PTIO\: Presir+bdd]:ci; drn of Ue equifr..:m Sung p: mnined erd O:nt,~itlededvion:omroL (:.p., coel Grd
<br />[oi!u wiUl bx=b:a>;, pains bNth c..5 psr.i: alas: Lis: n`,.
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<br />p'f1TE: Afor. :S_r. en: Au Pe'.Ivo:: E:.n sion ;: ctr.; U _~'; e•. b: nc:C:]wiN Nis eppic uion, i!0::: a ruCi; f: srv.: a!'O.Yy Cr.: :; plia:e :l: rsa cc]s
<br />h Lb: Oc ma aicvn r.: ahe: o! doss ~ c: yee: Osl xh: eo-s r.: ~{i; c; cna.
<br />Fr. SOU7tCE ADDRI:iS: Do ces Fi•':e P.O 6oa Thn isfe: tn: f`.•sfcallndonof the xou rc.Flee¢iodvde+rup.bleh indi[e¢slh::a:;llwcion erL =hrwe
<br />r..ejar lrpoFr. phi: L•sn:m. If lh; sour,: is porch!:, ioc lvC: ~-.: Ieations end Beset eScr, ~\t wur« .fll bt rp: nad Cvna; Cumior. of p:ra Cf cov n);
<br />tt\:r+iu, Ilsl fin: c; enling Ice+lio-.
<br />b. IJ"i ?4 eoordir_:; s r. sho='n en US G:oloFi:+l Survry rho) r. u; s Qin hsimdr ud lon;imd: if UR.1s mt tno~+n).
<br />i e ESTf.\1ATF,D COSS: Socr--: - E.:u o:irn:d opi~l cas: of it: cnlin tourcc (is~IvdinR mewl cquiprs:.q.
<br />b Nr Folludcn Comnl Fqufp<cm - &a:r 6: upiul and +.^.wI rp; mice cons Of Ne control cgviprrcm oN).
<br />!C E$-Tbf:l TF.D ]'s .{RT-LT D.ITE: TSrt es:irrssoed Ea:: cio~=s .:: Dnhionm smidip+lee`.:nlh:rgvird irsps:iaafarGul gfmvd=~iil br <e r.!vaa. I!d.<
<br />p nj::: e~min: s:!:;v of ea eai, ha. aF., hod dc•:I; ~-rcr;, C.: '_::u in i:: m> Ab and 6d v. ill b: lSe urx. COTE: L;~:nGaa prix: la r_u~: rf s p:-ni: it
<br />prd~ibn:C by Co!: n^CO Ssa;m:.
<br />c. AFE~ FILI]'G i eE: M1v S IOl.fA1 Glim &e p:r AFE~ .: L^h ri,:<. Initial and Fin+l Aronva Res v: ill be uxss:2 on u.l:wdy nk Lee- pre:via, sed mill
<br />b: rtqu:slcd 67 s;; en:c lerar A~\l:AL FEFS \VI LL 6~ BILLED FOR EACH SOURCE REQUIRING ,L~ APE\ TO CO}l:P. TIIE CO57S OF
<br />FF.RIODIC IXSPECT10~'S A\U ADI4ATSTRATiO.\'. A ::=r1 Lcu er- bated on Ne quartisy and ry'p; of pohubr:~ rr.Jred. For eRciGc iaferrution rhmd
<br />In f:rs tic AQCC n:p ~lasion tM1O. 7. S:clicn \'I.
<br />lie Th; Cori n(ecpvirq, end nuilin~ the euly sit will b: chs.~:d a eh; epplicans. Proceuind d:6p may occur if O:r .- go:riav ryertirp 0; xr.hsis.
<br />D. R;vie- rtqun:. eia urvelly add so both procc uin; rota en] pmcuinR lima The Division will consider the r_gcen en eRr. iel m::uion of 0: prorueinF
<br />Cudlin:> epaiLed by she Aa. The ea: nsian will eernif. o(L : comb<r of drys eLpssd bctvrm Diaimn rruilin~ 010: dnR pemul to 6e eppli: ul end ¢ccipl
<br />of lh: epyliu r.:'e <::rmeC~ by the Division, trot to rr:d IS Cn a. Hoveveq the Diritieo it tKK bound to corsid:r env wrmra rcciv<d eCu the I$ d.r lime
<br />period hpsc s, ur+':u bo'h :`t: Division end the gplic ca sLm: to e (L'r`.;r ene mion of the prxessing dadfir<x. A.+! Yiisierul6.-: an: rSs:pn itiurd b; 0:
<br />D:'•ition in p.~aidia, a LnC mC to.-spende rcc v.i:5 l`.: e; ;!i: e:.t ~+ill be billed so Ltie eppli<mt.
<br />\0 T)CE: 0\'CE A.~' MFLICATIO\ IS P.ECEI V-ED, ALL PROC FSSI\G TL\fE HTI.L DE CHARGED REGARDLESS OF }}IIET)IER A PER\^.T IS IS$liED
<br />U: \0T. IF A PROIF.CT 6 CA-\'C ELED. TIIE DI\1$105 $!iOLI.D 3E \OTI FLED IS 1VRITISG I}CVfEDLITEL)'. STATE LAIi' RF.QLT P,E$ TtlaT E\tIS,SIO\
<br />PER\QTS .5{A 1' 7+'OT 8E ISSUED ll-f1L FHOCESSI\~G FF.FJ ARE FAID. PROCF$$I.\C FEES ARF. RASED 0~ TIIE A\IOL1T Oi TLVl+`. SFF.t;I
<br />F.EVI F.\\l.\'C T71 F. APFLICAT105 ASD IiSGI~G TIIE I'F.~\IIT.
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