3096 I-70 Business Loop, Suite E Grand Junction, CO 81 0! "#one $970% &3-6!00 - 'a( $970% &3-6!0& )))*CedarCree+"ropert,-ana.

e/ent*co/

RENTAL APPLICATION
0#an+ ,ou 1or considerin. rentin. )it# Cedar Cree+ 2ea3t,* Our .oa3 is to ensure our residents #a4e a sa1e, con4enient, and a11orda53e #o/e to 3i4e in* "3ease read t#rou.# t#ese app3ication .uide3ines 5e1ore 1i33in. out t#e app3ication so ,ou )i33 #a4e an understandin. o1 our 0enant criteria and app3ication process* Application Fee Eac# app3icant /ust pa, a 6& *00 non-refundable app3ication 1ee, or a /arried coup3e /a, app3, to.et#er 1or on3, 6! *00* 0#is 1ee /ust 5e paid at t#e ti/e ,ou su5/it ,our app3ication* 7pp3ications are +ept on 1i3e 1or 90 da,s, a1ter )#ic# ti/e ,ou )i33 #a4e to reapp3,* Application Process 74ai3a53e properties /a, 5e 4ie)ed 5, /a+in. a s#o)in. appoint/ent or 5, c#ec+in. out a +e, t#rou.# our o11ice* 8a3id identi1ication is re9uired* E4er, person o4er t#e a.e o1 18 )#o )i33 reside in t#e #o/e /ust co/p3ete an app3ication in its entiret,, pa, an app3ication 1ee, and 5e appro4ed* 7pp3ication /a, ta+e 5et)een 1 to 3 5usiness da,s 1or processin.* Securit, deposit is re9uired at t#e ti/e o1 su5/ittin. ,our app3ication and is 100: re1unda53e i1 ,our app3ication is denied* Once ,our app3ication #as 5een appro4ed, ,ou /ust co/p3ete a Lease Si.nin. 7ppoint/ent )it#in 7 da,s* 'irst /ont#;s rent is due at t#e ti/e o1 3ease si.nin.* 'irst and 3ast /ont#;s rent /a, 5e re9uired in certain cases* I1 ,our app3ication is appro4ed and ,ou do not si.n a 3ease )it#in 7 da,s, or ,ou do not ta+e possession on t#e a.reed upon date, ,ou 1or1eit 6!00*00 o1 ,our securit, deposit* <our securit, deposit and 1irst /ont#;s rent /ust 5e paid in certi1ied 1unds $no cas# or persona3 c#ec+s%* Application Requirements 2enta3 =istor, 8eri1ication Ban+ 7ccount 8eri1ication "ersona3 2e1erence C#ec+ Credit 2eport E/p3o,/ent 8eri1ication Cri/ina3 Bac+.round C#ec+ -ust 5e 18 ,ears o3d to app3,> app3icants under &1 /a, re9uire a co-si.ner* 7n, 1a3se, incorrect or o/itted in1or/ation )i33 5e cause 1or re?ection o1 ,our app3ication* Cedar Cree+ 2ea3t, reser4es t#e ri.#t to re1use an, app3icant not /eetin. appro4a3 re9uire/ents, or re9uire a co-si.ner* Pet Policy @ot a33 o1 our renta3 properties a33o) pets* 7 non-re1unda53e 61 0*00 pet 1ee is re9uired* 2enter;s insurance /a, 5e re9uired 1or tenants )it# pets* 7n additiona3 pet deposit /a, 5e re9uired 1or 3ar.e pets and /u3tip3e pets*

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IF O! "A#E $EEN CON#ICTE% OF A FELON IN T"E LA&T '( EAR&) %O NOT APPL *

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O''ICE ASE O@L< B CO @O0 D2I0E BELOD

E FFFFF o1 FFFFF

7pp3icant @a/e FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF "ropert, 7pp3,in. 'or FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF G H Satis1actor, I H Ansatis1actor, FFFFF "resent Land3ord FFFFF "re4ious Land3ord FFFFF 8isua3 Inspection FFFFF 7pp3icant E/p3o,er

Co//ents FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF

FFFFF Co-7pp3icant E/p3o,er FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFF Ban+ FFFFF Cri/ina3 Bac+.round FFFFF E4ictions FFFFF Ban+ruptc, FFFFF Credit Score FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFF Co33ectionsJFFFFFFFFFFFFFFFFFFFFFFFFFFFFF C#ar.e O11sJFFFFFFFFFFFFFFFFFFFFFFFFFFFF Late "a,/entsJFFFFFFFFFFFFFFFFFFFFFFFFFF 7/ount "ast CueJFFFFFFFFFFFFFFFFFFFFFFFF Notes +onies Recei,ed

FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF

CateJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF Cop, o1 ICJFFFFFFFFFFFFFFFFFFFFFFFFFFFFF 7pp3ication 'eeJFFFFFFFFFFFFFFFFFFFFFFFFF Securit, CepositJFFFFFFFFFFFFFFFFFFFFFFFF 2entJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF APPRO#E%------%ENIE%---------$y.----------FFFFF $y.---------------

%ate.---------------------------------

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PLEA&E CO+PLETE T"E FOLLO/IN0.

Personal Information 7pp3icant @a/eJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF "#oneJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF Socia3 Securit, EJFFFFFFFFFFFFFFFFFFFFFF COBJFFFFFFFFFF Cri4ers License EJFFFFFFFFFFFFFFFFFFFFFFF Co-7pp3icant @a/eJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF "#oneJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF Socia3 Securit, EJFFFFFFFFFFFFFFFFFFFFFF COBJFFFFFFFFFF Cri4er License EJFFFFFFFFFFFFFFFFFFFFFFF =o) /an, peop3e )i33 3i4e in t#e unitK 7du3tsFFFFFFFFFFFFFF C#i3drenFFFFFFFFFFFFFF "etsFFFFFFFFFFFFFF Dei.#t, 0,pe L 7.e o1 "etsJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF D#at unit are ,ou app3,in. to rentKFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF =o) soon do ,ou need to /o4e inKFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF Residential "istory "resent 7ddressJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF Cit,JFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF StateJFFFFFFFFFF Mip CodeJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF Land3ord @a/eJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF "#oneJ FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF =o) Lon. =a4e <ou Li4ed 0#ereKFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF I1 ,ou #a4e 3i4ed at ,our "resent 7ddress 1or 3ess t#an & <ears, co/p3ete t#e 1o33o)in.J "rior 7ddressJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF Cit,JFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF StateJFFFFFFFFFF Mip CodeJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF Land3ord @a/eJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF "#oneJ FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF =a4e ,ou e4er 5een e4ictedKFFFFFFFFFFFFFFFFFFFFFFFFFFFF D#enKFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF Employment "istory 7pp3icant E/p3o,erJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF "#oneJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF "ositionJFFFFFFFFFFFFFFFF =o) Lon.JFFFFFFF -ont#3, Inco/eJFFFFFFFFFFFFFF "a, CatesJFFFFFFFFFFFFF "re4ious E/p3o,erJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF "#oneJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF "ositionJFFFFFFFFFFFFFFFFFFFFFFFFFFFFF =o) Lon.KFFFFFFF -ont#3, Inco/eJFFFFFFFFFFFFFFFFFFFFFFF Co-7pp3icantJ E/p3o,erJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF "#oneJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF

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"ositionJFFFFFFFFFFFFFFFFF =o) Lon.JFFFFFF -ont#3, Inco/eJFFFFFFFFFFFFFFFF "a, CatesJFFFFFFFFFFF "re4ious E/p3o,erJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF "#oneJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF "ositionJFFFFFFFFFFFFFFFFFFFFFFFFFFFFF =o) Lon.KFFFFFF -ont#3, Inco/eJFFFFFFFFFFFFFFFFFFFFFFFF $an1in2 Information @a/e o1 Ban+JFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF "#oneJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF C#ec+in. 7ccount EJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF Sa4in.s 7ccount EJFFFFFFFFFFFFFFFFFFFFFF =a4e ,ou e4er 1i3ed 1or 5an+ruptc,KFFFFFFFFFFFFFFFFFFFFFFF D#enKFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF References @a/e 1% FFFFFFFFFFFFFFFFFFFFFFFFFFFF &% FFFFFFFFFFFFFFFFFFFFFFFFFFFF 3% FFFFFFFFFFFFFFFFFFFFFFFFFFFF Emer2ency Contact @a/eJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF "#oneJFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF 2e3ations#ip FFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFF "#one FFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFF

#e3icles -a+eN-ode3 <ear Co3or 0a. E State

FFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFF FFFFFFFFFFFF FFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFF FFFFFFFFFFFF FFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFF B, si.nin. t#is app3ication, app3icant$s% represent t#at a33 o1 t#e in1or/ation contained #erein is true, correct, and co/p3ete, and #ere5, aut#oriOes an in4esti.ati4e consu/er report, inc3udin. 5ut not 3i/ited to residentia3 #istor, $renta3 or /ort.a.e%, cri/ina3 #istor,, court and credit records* 7pp3icant$s% ac+no)3ed.e t#at 1a3se, incorrect or o/itted in1or/ation #erein /a, constitute .rounds 1or re?ection o1 t#is app3ication, ter/ination o1 ri.#t o1 occupanc,, andNor 1or1eiture o1 1ees or deposits and /a, constitute a cri/ina3 o11ense under t#e 3a)s o1 t#e State* FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF Si.nature Cate -----------------------------------------------------------------------------------------Si.nature Cate

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"LE7SE 2E7C C72E'ALL<

CISCLOSA2E 0#is docu/ent ser4es so3e3, as a c3ear and conspicuous )ritten disc3osure as re9uired 5, t#e 'edera3 'air Credit 2eportin. 7ct set 1ort# in Section 60! $5% to t#e app3icant t#at a socia3 securit,, /otor 4e#ic3e 4eri1ication, education, pre4ious e/p3o,/ent, credit, c#aracter, .enera3 reputation, persona3 c#aracteristics, /ode o1 3i4in. and a cri/ina3 5ac+.round 4eri1ication /a, 5e o5tained 1or t#e purpose o1 t#is tenant app3ication* B, t#e si.nature 5e3o), t#e 7pp3icant ac+no)3ed.es t#at B7CPG2OA@C I@'O AS7* #as /ade t#is disc3osure* 7""LIC7@0 7A0=O2IM70IO@ 7@C CO@SE@0 'O2 2ELE7SE O' I@'O2-70IO@ 0#is re3ease and aut#oriOation ac+no)3ed.es t#at ---Cedar Cree+ 2ea3t, LLCF/a, no), or an, ti/e )#i3e I a/ rentin., conduct a 4eri1ication o1 /, education, pre4ious tenant #istor,, credit #istor,, contact persona3 re1erences, /otor 4e#ic3e records, conduct dru. testin. and to recei4e an, cri/ina3 #istor, in1or/ation pertainin. to /e )#ic# /a, 5e in t#e 1i3es o1 an, 'edera3, State, or Loca3 cri/ina3 ?ustice a.enc,, and to 4eri1, an, ot#er in1or/ation dee/ed necessar, to 1u31i33 t#e 3and3ord re9uire/ents* 0#e resu3ts o1 t#is 4eri1ication process )i33 5e used to deter/ine tenant e3i.i5i3it, under --Cedar Cree+ 2ea3t, LLCFFtenant po3icies* In t#e e4ent t#at in1or/ation 1ro/ t#e report is uti3iOed in )#o3e or in part in /a+in. an ad4erse action decision )it# re.ard to ,our potentia3 renter, 5e1ore /a+in. t#e ad4erse decision, )e )i33 pro4ide ,ou )it# a cop, o1 t#e consu/er report and a description in )ritin. o1 ,our ri.#ts under t#e 3a)* I aut#oriOe Bac+.round In1o AS7*, and an, o1 its a.ents, to disc3ose ora33, and in )ritin. t#e resu3ts o1 t#is 4eri1ication process to t#e desi.nated aut#oriOed representati4e o1--Cedar Cree+ 2ea3t, LLC---* I 3a,e read and understand t3is release and consent) and I aut3ori4e t3e bac12round ,erification* I aut#oriOe persons, sc#oo3s, current and 1or/er e/p3o,ers, and ot#er or.aniOations and 7.encies to pro4ide Bac+.round In1o AS7* )it# a33 in1or/ation t#at /a, 5e re9uested* I #ere5, re3ease a33 o1 t#e persons and 7.encies pro4idin. suc# in1or/ation 1ro/ an, and a33 c3ai/s and da/a.es connected )it# t#eir re3ease o1 an, re9uested in1or/ation* I a.ree t#at an, cop, o1 t#is docu/ent is as 4a3id as t#e ori.ina3* I do #ere5, a.ree to 1ore4er re3ease and disc#ar.e--Cedar Cree+ 2ea3t, LLC Bac+.round In1o AS7* and t#eir associates to t#e 1u33 e(tent per/itted 5, 3a) 1ro/ an, c3ai/s, da/a.es, 3osses, 3ia5i3ities, costs and e(penses, or an, ot#er c#ar.e or co/p3aint 1i3ed )it# an, 7.enc, arisin. 1ro/ retrie4in. and reportin. o1 in1or/ation* 7ccordin. to t#e 'edera3 'air Credit 2eportin. 7ct, I a/ entit3ed to +no) i1 e/p3o,/ent )as denied 5ased on in1or/ation o5tained 5, /, prospecti4e e/p3o,er and to recei4e a disc3osure o1 t#e pu53ic record in1or/ation and o1 t#e nature and scope o1 t#e in4esti.ati4e report* CONFI%ENTIAL INFOR+ATION FOR PO&ITI#E I%ENTIFICATION P!RPO&E& ONL

_____________________________________________
Applicant Last Name Fi st Name !i""le Name

___________
List Ot#e Names $se" %ate of &i t# 'ocial 'ec( it) N(m*e

____________
% i+e s License N(m*e 'tate % i+e s License ,ss(e" Last name on % i+e s License

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"LE7SE 2E7C C72E'ALL<

CISCLOSA2E 0#is docu/ent ser4es so3e3, as a c3ear and conspicuous )ritten disc3osure as re9uired 5, t#e 'edera3 'air Credit 2eportin. 7ct set 1ort# in Section 60! $5% to t#e app3icant t#at a socia3 securit,, /otor 4e#ic3e 4eri1ication, education, pre4ious e/p3o,/ent, credit, c#aracter, .enera3 reputation, persona3 c#aracteristics, /ode o1 3i4in. and a cri/ina3 5ac+.round 4eri1ication /a, 5e o5tained 1or t#e purpose o1 t#is tenant app3ication* B, t#e si.nature 5e3o), t#e 7pp3icant ac+no)3ed.es t#at B7CPG2OA@C I@'O AS7* #as /ade t#is disc3osure* 7""LIC7@0 7A0=O2IM70IO@ 7@C CO@SE@0 'O2 2ELE7SE O' I@'O2-70IO@ 0#is re3ease and aut#oriOation ac+no)3ed.es t#at ---Cedar Cree+ 2ea3t, LLCF/a, no), or an, ti/e )#i3e I a/ rentin., conduct a 4eri1ication o1 /, education, pre4ious tenant #istor,, credit #istor,, contact persona3 re1erences, /otor 4e#ic3e records, conduct dru. testin. and to recei4e an, cri/ina3 #istor, in1or/ation pertainin. to /e )#ic# /a, 5e in t#e 1i3es o1 an, 'edera3, State, or Loca3 cri/ina3 ?ustice a.enc,, and to 4eri1, an, ot#er in1or/ation dee/ed necessar, to 1u31i33 t#e 3and3ord re9uire/ents* 0#e resu3ts o1 t#is 4eri1ication process )i33 5e used to deter/ine tenant e3i.i5i3it, under --Cedar Cree+ 2ea3t, LLCFFtenant po3icies* In t#e e4ent t#at in1or/ation 1ro/ t#e report is uti3iOed in )#o3e or in part in /a+in. an ad4erse action decision )it# re.ard to ,our potentia3 renter, 5e1ore /a+in. t#e ad4erse decision, )e )i33 pro4ide ,ou )it# a cop, o1 t#e consu/er report and a description in )ritin. o1 ,our ri.#ts under t#e 3a)* I aut#oriOe Bac+.round In1o AS7*, and an, o1 its a.ents, to disc3ose ora33, and in )ritin. t#e resu3ts o1 t#is 4eri1ication process to t#e desi.nated aut#oriOed representati4e o1--Cedar Cree+ 2ea3t, LLC---* I 3a,e read and understand t3is release and consent) and I aut3ori4e t3e bac12round ,erification* I aut#oriOe persons, sc#oo3s, current and 1or/er e/p3o,ers, and ot#er or.aniOations and 7.encies to pro4ide Bac+.round In1o AS7* )it# a33 in1or/ation t#at /a, 5e re9uested* I #ere5, re3ease a33 o1 t#e persons and 7.encies pro4idin. suc# in1or/ation 1ro/ an, and a33 c3ai/s and da/a.es connected )it# t#eir re3ease o1 an, re9uested in1or/ation* I a.ree t#at an, cop, o1 t#is docu/ent is as 4a3id as t#e ori.ina3* I do #ere5, a.ree to 1ore4er re3ease and disc#ar.e--Cedar Cree+ 2ea3t, LLC Bac+.round In1o AS7* and t#eir associates to t#e 1u33 e(tent per/itted 5, 3a) 1ro/ an, c3ai/s, da/a.es, 3osses, 3ia5i3ities, costs and e(penses, or an, ot#er c#ar.e or co/p3aint 1i3ed )it# an, 7.enc, arisin. 1ro/ retrie4in. and reportin. o1 in1or/ation* 7ccordin. to t#e 'edera3 'air Credit 2eportin. 7ct, I a/ entit3ed to +no) i1 e/p3o,/ent )as denied 5ased on in1or/ation o5tained 5, /, prospecti4e e/p3o,er and to recei4e a disc3osure o1 t#e pu53ic record in1or/ation and o1 t#e nature and scope o1 t#e in4esti.ati4e report* CONFI%ENTIAL INFOR+ATION FOR PO&ITI#E I%ENTIFICATION P!RPO&E& ONL

_____________________________________________
-o-Applicant Last Name Fi st Name !i""le Name

___________
List Ot#e Names $se" %ate of &i t# 'ocial 'ec( it) N(m*e

____________
% i+e s License N(m*e 'tate % i+e s License ,ss(e" Last name on % i+e s License

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RA-Oct29-2013

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