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