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  • Adobe Scan Feb 28, 2022

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    This document appears to be a form listing resources owned by an individual including the type of resource, location, value, and owner. It requests a signature and date from the individual or their spouse/representative. The document contains no other information to summarize.

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    Adobe Scan Feb 28, 2022 (1)

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    This document appears to be a form listing resources owned by an individual including the type of resource, location, value, and owner. It requests a signature and date from the individual or their spouse/representative. The document contains no other information to summarize.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Download as pdf or txt
    8 views1 page

    Adobe Scan Feb 28, 2022

    Uploaded by

    yeshakbir
    This document appears to be a form listing resources owned by an individual including the type of resource, location, value, and owner. It requests a signature and date from the individual or their spouse/representative. The document contains no other information to summarize.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    Description Owned by

    (Type of Resource) Where Located Value


    Whom
    6.

    8.

    |10.
    Signature: Z_ASHy
    (Spouse Authorized
    or
    1ake u Date:2L23|2ol2_
    Representative)

    Case #: 124149882 Page 2 of 4 Correspondence #: 761015031

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