| Description | Est. Value |
| 1. _____________________________________ | ____________ |
| 2. _____________________________________ | ____________ |
| 3. _____________________________________ | ____________ |
| 4. _____________________________________ | ____________ |
| 5. _____________________________________ | ____________ |
| 6. _____________________________________ | ____________ |
| ________ | __________________________________ | _____________ | |
| Member# | Signature | Date |