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1) Maximum value of account during calendar year
reported
2) Type of account
a. Bank b. Securities c. Other
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Information On Financial Account(S) owned Separately
1) Maximum value of account during calendar year
reported
2) Type of account
a. Bank b. Securities c. Other
3) Name of the Financial Institution in which account is
held
Account number
Mailing Address (Number, Street, Suite Number) of financial
institution in which account is held.
City
State
ZIP/Postal Code
Country
FILER INFORMATION
Information On Financial Account(S) owned Separately
1) Maximum value of account during calendar year
reported
2) Type of account
a. Bank b. Securities c. Other
3) Name of the Financial Institution in which account is
held
Account number
Mailing Address (Number, Street, Suite Number) of financial
institution in which account is held.
City
State
ZIP/Postal Code
Country
FILER INFORMATION
Information On Financial Account(S) owned Separately
1) Maximum value of account during calendar year
reported
2) Type of account
a. Bank b. Securities c. Other
3) Name of the Financial Institution in which account is
held
Account number
Mailing Address (Number, Street, Suite Number) of financial
institution in which account is held.
City
State
ZIP/Postal Code
Country
FILER INFORMATION
Information On Financial Account(S) owned Separately
1) Maximum value of account during calendar year
reported
2) Type of account
a. Bank b. Securities c. Other
3) Name of the Financial Institution in which account is
held
Account number
Mailing Address (Number, Street, Suite Number) of financial
institution in which account is held.
City
State
ZIP/Postal Code
Country