293-22 Exhibit A.pdf

Article 3.0 I STOCKHOLDER DISCLOSURE CERTIFICATION I certify that the list below contains the names and home addresses of all stockholders holding l 0% or more of the issued and outstanding stock of the undersigned. V I certify that no one stockholder owns 10% or more of the issued and outstanding stock of the undersigned. ---- PLEASE CHECK TYPE OF BUSINESS ORGANIZATION: Cv,.,..p/ffl{ ./ Partnership _ _ Limited Partnership _ _ Limited Liability~· __ V_ Corporation _ _ Sole Proprietorship_ _ Limited Liability Partnership_ _ Subchapter S Corp. _ _ PLEASE CHECK APPROPRIATE BOXES AND SIGN BELOW Stockholders HOME ADDRESS: -------------- NAME: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ HOME ADDRESS: -------------- NAME: ------------------ HOME ADDRESS: --------------- 33