HOUSE_OVERSIGHT_019085

FD-302a (Rev. 10-6-95)

31B-MM-108062

Continuation of FD-302 of | ,On 02/08/2007 Page _2_ A records check of[ provided the following v6 b7C

information:

Race:

Sex:

Date of birth:

Social Security Number:

: HOUSE_OVERSIGHT_019085 —