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Get BCA 12.20 2003

__________ $_____________ TOTAL (COMPLETE BOTH SIDES OF DOCUMENT) Printed by authority of the State of Illinois. June 2006 - 10M - C 152.15 $_____________ b. List all cancellations of shares not previously reported to the Secretary of State and give the cost. Date of Cancellation ______________ Class _______________ Number of Shares Cancelled ____________________ Cost ______________ $_____________ $_____________ TOTAL $_____________ 5. Issued shares at date of execution: Class Series Pa.

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