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era nal intormation <br /> Are you a registered voter? <br /> Yes - -. No <br /> if Yes. where are you registered? ST Aa:'tiie A-: �+ • <br /> 13. Address(es) at w ich .you have lived during preceding ten years. (Begin with present <br /> or last address and work back.) <br /> No. and Street City and State Dates <br /> 3 its SIDE re Rj 'yrI . .. / 3 <br /> 3 <br /> LA /el /y 7 G <br /> 14. Kind, rame. an�i location of every business or occupation you have been engaged in <br /> during the- preceding ten years. (Begin with present or last address ,-and work back.) <br /> Location: Street Address Nature of Business or <br /> Business .or Occupation City and State Occupation - <br /> T4&% F 3as r- tied L I s <br /> 15. Names ai;,i a;:Lirc ,- es of -c.:r erq)1 yers ar,�'J par %ers , if any , for tac prccc.!. .:g ten <br /> •car s . (Begin with prc;cn: or last one first and work Lack .) <br /> Names: Employers or partners Addresses: nCity and State Pates <br /> �i0d 11V3 <br /> MARL, U J�7 2 - /s 8 3 <br /> lit �.Lo C k Z /A) SiG �aX£4 VA 'mat <br /> od ot P. elm b%£ 3 q'6 E m 'yyj,f,,��,. <br /> �l J <br />