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$100 TANGIBLE PROPERTY SUMMARY: TOTAL ITEM COUNT:________________________ TOTAL # OF OWNERS: ______________________ SECURITY PROPERTY SECURITIES SC01 SC02 SC03 SC04 SC05 SC06 SC07 SC08 SC09 SC10 SC11 SC12 SC13 SC14 SC15 SC16 SC17 SC18 SC19 SC20 SC21 SC97 SC99 TOTAL # OF ITEMS: ___________________________ DIVIDENDS INTEREST (BOND COUPONS) PRINCIPAL PAYMENTS EQUITY PAYMENTS PROFITS FUNDS PAID TO PURCHASE SHARES FUNDS FOR STOCKS AND BONDS SHARES OF STOCK (RETURNED BY POST OFFICE) CASH FOR FRACTI.

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