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And complete and includes all property required to be reported which is owned, claimed, possessed, controlled, or managed by the person named as the assessee in this statement at 12:01 a.m. on January 1, 2015. SIGNATURE OF ASSESSEE OR AUTHORIZED AGENT* DESCRIPTION (R) Year of Mfr. DECLARATION BY ASSESSEE OWNERSHIP TYPE (R) Proprietorship t Year of Acq. DATE t NAME OF ASSESSEE OR AUTHORIZED AGENT* (typed or printed) TITLE NAME OF LEGAL ENTITY (other than DBA) (typed or printed).

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