ࡱ> @ pbjbjFF ,, FrHHHH$$$82%%0K:&p((((?+(g,-\[J]J]J]J]J]J]J$jLRNXJik2*^?+k2k2JHH(([J444k2HR(([J4k2[J44C|"E(& G\T&$2DF<K00K-DO2O$EHHHHOEw-:.4/E0&w-w-w-JJ$ 4 STATE OF SOUTH CAROLINA DEPARTMENT OF CONSUMER AFFAIRS CORPORATE OR LIMITED LIABILITY (LLC) INFORMATION SUPPLEMENTAL FORM C S.C. Code Ann. 40-58-10 through -110 (Supp. 1997)  HYPERLINK "http://www.scconsumer.gov/" ww.scconsumer.gov 803-734-4236/800-922-1594 DO NOT FAX THIS FORM The following information must be provided for all Corporations or Limited Liability Companies ("LLC"). Enclose a CERTIFICATE OF GOOD STANDING from the Secretary of State of South Carolina and your ARTICLES OF INCORPORATION/ORGANIZATION. INCOMPLETE INFORMATION COULD RESULT IN DELAY OR DENIAL OF YOUR APPLICATION. Additionally, if any of the information on this form changes submit a new form. 1.Name of Corporation/LLC:  FORMTEXT      2.d/b/a (doing business as):  FORMTEXT      3.Physical Address of Corporation/LLC: (Include City, State and Zip)  FORMTEXT       FORMTEXT       FORMTEXT      4.Mailing Address of Corporation/LLC: (Include City, State and Zip) FORMTEXT       FORMTEXT       FORMTEXT      5.List the names of all officers and principals of the Corporation or managers/members of the LLC: (include each officer's percentage of ownership and title with the company. OFFICER/PRINCIPALTITLEPERCENTAGE OF OWNERSHIP FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      6.List the agent for service of process for the Corporation /LLC in South Carolina (This is a person, either yourself or someone you designate, to receive any  legal documents served on your business in the event of legal action):  FORMTEXT      7.Physical and mailing address in South Carolina of agent for service of process for the Corporation/LLC, including ZIP code and county: FORMTEXT       FORMTEXT       FORMTEXT      I swear or affirm and certify that I have completed and/or revie9^ijklm̼r]J8&"hH^:hZ-5CJOJQJ]aJ"hH^:hZ-5CJOJQJ\aJ%hH^:hZ-5>*CJOJQJ\aJ(jhH^:h5CJUaJmHnHu3jh55>*CJOJQJU\aJmHnHuhZ-B*CJOJQJaJphh7'HB*CJOJQJaJphhiB*CJOJQJaJphhTMB*CJOJQJaJphhhZ-CJOJQJaJhZ-CJOJQJaJ0jhhZ-CJOJQJUaJmHnHu9k   % & j 0*L0*L0*V0*V0*V0*V0*V0*00*<0*Z0*Z|0*{% & p@ P !d$7$8$H$IfgdTM & p@ P !d7$8$H$gdFa'$ & p@ P !d7$8$H$`a$gdFa$a$gdZ- %d O gdZ- Voop nXG3&h*)hZ-0J5CJOJQJ\aJ h*)h*)0JCJOJQJaJ+jh*)h4P5CJOJQJUaJ h*)0J6CJOJQJ]aJ)jh*)0J6CJOJQJU]aJ)hZ-0J56:;CJOJQJ\aJ/hH^:hZ-0J56:;CJOJQJ\aJ"hH^:hZ-5CJOJQJ]aJh*)5CJOJQJ]aJhZ-5CJOJQJ]aJh3{5CJOJQJ]aJ   % & ' h j l n Ŵ{i{TF8hFaCJOJQJ^JaJh5CJOJQJ^JaJ)hTMh5B*CJOJQJ^JaJph#h,UB*CJOJQJ^JaJph#h*)B*CJOJQJ^JaJph)hTMhTMB*CJOJQJ^JaJph#hTMB*CJOJQJ^JaJph hFa5CJOJQJ\^JaJ,hFa5>*B*CJOJQJ\^JaJphhZ-5CJOJQJ/hH^:h||0J56:;CJOJQJ\aJj l n p r x {\({9{{Rkd $$Ifl0h*4) t44 la% & p@ P !d$7$8$H$IfgdFa$$If`a$gd[R?kd$$Ifl*+ t44 lan p r x ͸rVH:h*)CJOJQJ^JaJhCJOJQJ^JaJ7jh}B*CJOJQJU^JaJmHnHphu8jh}h}B*CJOJQJU^JaJph#h}B*CJOJQJ^JaJph,jh}B*CJOJQJU^JaJph)hTMh}B*CJOJQJ^JaJphh}CJOJQJ^JaJhFaCJOJQJ^JaJ,hFahFa5B*CJOJQJ^JaJphx  {p{{b{R{E\({ $If`gdTM$$If`a$gd[Rxkd#$$Ifl\h !*\ H t44 la% & p@ P !d$7$8$H$IfgdTM  D F {{ {p{{ $If`gdTM$$If`a$gd[RRkd$$Ifl0h*4) t44 la    2 4 6 @ B F H N T ϟjXjA,jh}B*CJOJQJU^JaJph#h*)B*CJOJQJ^JaJph)hTMh}B*CJOJQJ^JaJphh5CJOJQJ^JaJ#h}B*CJOJQJ^JaJph.jh}CJOJQJU^JaJmHnHu/j{h}hnCJOJQJU^JaJ#jh}CJOJQJU^JaJh}CJOJQJ^JaJ hTMh}CJOJQJ^JaJF H J L {w{j\({ $If`gdTM$$If`a$gd[Rxkd$$Ifl\h !*\ H t44 laL N T   {{x {x {xp{x{% & p@ P !d$7$8$H$IfgdTM$$If`a$gd[RRkd$$Ifl0h*4) t44 la     " $ & 0 2 4 6 : < > R T V ` b d ̰̞{̞^̰̞{̞A̰̞8jh}hnB*CJOJQJU^JaJph8jh}hnB*CJOJQJU^JaJphh}CJOJQJ^JaJ)hTMh}B*CJOJQJ^JaJph#h}B*CJOJQJ^JaJph7jh}B*CJOJQJU^JaJmHnHphu,jh}B*CJOJQJU^JaJph8jGh}hnB*CJOJQJU^JaJph  4 6 wsNNp{N% & p@ P !d$7$8$H$IfgdTM$$If`a$gd[R{kd$$Ifl4F\h !*``\ H` t44 la6 8 : < d f wsNNp{N% & p@ P !d$7$8$H$IfgdTM$$If`a$gd[R{kd$$Ifl4F\h !*  \ H  t44 lad f h j l n t | ν꫙mPm4m7jh}B*CJOJQJU^JaJmHnHphu8j h}hnB*CJOJQJU^JaJph,jh}B*CJOJQJU^JaJph)hTMh*)B*CJOJQJ^JaJph#h}B*CJOJQJ^JaJph#h*)B*CJOJQJ^JaJph h5h5CJOJQJ^JaJh5CJOJQJ^JaJh}CJOJQJ^JaJ)hTMh}B*CJOJQJ^JaJphf h j l ws{f\({ $If`gdTM$$If`a$gd[R{kda$$Ifl4F\h !*  \ H  t44 lal n t "{{x {x {Sp{S{% & p@ P !d$7$8$H$Ifgd,U% & p@ P !d$7$8$H$IfgdTM$$If`a$gd[RRkd@ $$Ifl0h*4) t44 la"&(*>@BLNRVXZnpr|~ǰeǰHe:h(CJOJQJ^JaJ8ju h}hnB*CJOJQJU^JaJph7jh}B*CJOJQJU^JaJmHnHphu8j" h}hnB*CJOJQJU^JaJph#h}B*CJOJQJ^JaJph,jh}B*CJOJQJU^JaJph)hTMh}B*CJOJQJ^JaJphh}CJOJQJ^JaJ)h,Uh}B*CJOJQJ^JaJph"$&(PwsN)p{% & p@ P !d$7$8$H$Ifgd,U% & p@ P !d$7$8$H$IfgdTM$$If`a$gd[R{kdC $$Ifl4F\h !*``\ H` t44 laPRTVX^wN)% & p@ P !d$7$8$H$IfgdTM$$If`a$gd[R{kd $$Ifl4F\h !*  \ H  t44 la% & p@ P !d$7$8$H$Ifgd,UXp{^wN{A\({ $If`gdTM$$If`a$gd[R{kd $$Ifl4F\h !*  \ H  t44 la% & p@ P !d$7$8$H$Ifgd,U *,Z\^`bvxzӰӐ~pX~@~.jh ICJOJQJU^JaJmHnHu/jh IhnCJOJQJU^JaJh ICJOJQJ^JaJ#jh ICJOJQJU^JaJh,UCJOJQJ^JaJ#h,Uh,U5CJOJQJ^JaJ#h,UhTM5CJOJQJ^JaJ hTMhTMCJOJQJ^JaJhTMCJOJQJ^JaJh(CJOJQJ^JaJ hTMh(CJOJQJ^JaJ{{\({>{{T{RkdW$$Ifl0h*4) t44 la $If`gdTM$$If`a$gd[RRkd $$Ifl0h*4) t44 la ,\P{z{j{Z{ZT{ZP{$$If`a$gd,U$$If`a$gd[Rxkd$$Ifl\hHt"*,( t44 la $If`gdTM\^`VF{9{9T{ $If`gdTM$$If`a$gd[Rkd$$Ifl\hHt"*,(  t(44 lap((*,.B߉qY/jh IhnCJOJQJU^JaJ/j$h IhnCJOJQJU^JaJ/jh IhnCJOJQJU^JaJh,UCJOJQJ^JaJ.jh ICJOJQJU^JaJmHnHu/jah IhnCJOJQJU^JaJh ICJOJQJ^JaJ#jh ICJOJQJU^JaJ,TP{w{g{Z{ZT{P{ $If`gdTM$$If`a$gd[RxkdM$$Ifl\hHt"*,( t44 la$$If`a$gd IBDFPRXZnpr|~սկասկաqսկաYսկKh(CJOJQJ^JaJ/jIh IhnCJOJQJU^JaJ/jh IhnCJOJQJU^JaJ/j]h IhnCJOJQJU^JaJh ICJOJQJ^JaJh,UCJOJQJ^JaJ.jh ICJOJQJU^JaJmHnHu#jh ICJOJQJU^JaJ/jh IhnCJOJQJU^JaJTVX{w{j{jT{ZP{$$If`a$gd I $If`gdTM$$If`a$gd[Rxkd$$Ifl\hHt"*,( t44 la{w{j\({ $If`gd5$$If`a$gd[Rxkd$$Ifl\hHt"*,( t44 la\´£kSE7h ICJOJQJ^JaJh'=CJOJQJ^JaJ.jh-CJOJQJU^JaJmHnHu/j3h-h-CJOJQJU^JaJh-CJOJQJ^JaJ#jh-CJOJQJU^JaJ h5h,UCJOJQJ^JaJh*)CJOJQJ^JaJ hTMh,UCJOJQJ^JaJh,UCJOJQJ^JaJh(CJOJQJ^JaJ h5h(CJOJQJ^JaJ{{{ { $If`gd- $If`gdTM$$If`a$gd[RRkd$$Ifl0h*4) t44 lag{}{} { $If`gd($$If`a$gd[Rekd$$IflFh*l  t    44 la{{e@{eD{% & p@ P !d$7$8$H$Ifgd,U$$If`a$gd[Rekdb$$IflFh* t    44 la   "68:DFHLNPdvhKvh8jAh-h-B*CJOJQJU^JaJphh ICJOJQJ^JaJ7jh-B*CJOJQJU^JaJmHnHphu8jh-h-B*CJOJQJU^JaJph#h-B*CJOJQJ^JaJph,jh-B*CJOJQJU^JaJph#h IB*CJOJQJ^JaJph)h,Uh IB*CJOJQJ^JaJph HwaaD{% & p@ P !d$7$8$H$Ifgd,U$$If`a$gd[Rhkd}$$Ifl4Fh*`` t    44 laHJLNvwaaD{% & p@ P !d$7$8$H$Ifgd,U$$If`a$gd[Rhkd$$Ifl4Fh*   t    44 ladfhrtvxz|hjjjjjj̛̰jUSUjE0E)he'he'B*CJOJQJ^JaJphhe'CJOJQJ^JaJU)h,UhTMB*CJOJQJ^JaJph)h[RhnB*CJOJQJ^JaJphhnCJOJQJ^JaJh ICJOJQJ^JaJ)h,Uh IB*CJOJQJ^JaJph7jh-B*CJOJQJU^JaJmHnHphu,jh-B*CJOJQJU^JaJph8j{h-h-B*CJOJQJU^JaJphvxz|w{u\({$$7$8$H$Ifa$gd[R$$If`a$gd[Rhkd$$Ifl4Fh*   t    44 la|~jjj{{\({={RkdD$$Ifl0h*4) t44 la $7$8$H$Ifgd$$If`a$gd[RRkd$$Ifl0h*4) t44 lawed all information on this form and that all information contained herein is true and accurate. I further certify that I understand that giving false information constitutes cause for denial or revocation of my application and subjects me to criminal prosecution for perjury. I acknowledge that I have a duty and agree to update and correct this information as it changes. ______________________________________________ FORMTEXT      Signature of Member/EmployeeType or Print your name and Business Relationship or TitleSWORN TO AND SUBSCRIBED before me this _________ day of _________________________, 20__ _________________________________________________ Notary Public For ___________________________________ My Commission Expires: _____________________________ The South Carolina Freedom of Information Act may require the Department of Consumer Affairs to release this form as a public record. Mortgage Broker Supplemental Form C Rev. 12/04 Page  PAGE 1 of 1 Street Address 3600 Forest Drive Columbia, SC 29204-4406 Mailing Address P.O. Box 5757 Columbia, SC 29250-5757 jjjj\kk\({{u{g{g{ $7$8$H$Ifgd$$If`a$gd[RRkd$$Ifl0h*4) t44 la($ & p@ P !d$7$8$H$Ifa$gd,UjjZk\k^krktkvkkkkkkk6l8ll@lDlDnFn˴iTT?)hhB*CJOJQJ^JaJph)hhB*CJOJQJ^JaJph7jh IB*CJOJQJU^JaJmHnHphu8jbh IhnB*CJOJQJU^JaJph#h IB*CJOJQJ^JaJph,jh IB*CJOJQJU^JaJph)he'hB*CJOJQJ^JaJph#hB*CJOJQJ^JaJphhCJOJQJ^JaJkkkk8l{{y{k{ $7$8$H$Ifgd$$7$8$H$Ifa$gd[R$$If`a$gd[Rekd$$IflFh* t    44 la8l:ll@l{{y{k{ $7$8$H$Ifgd$$7$8$H$Ifa$gd[R$$If`a$gd[Rekd} $$IflFh* t    44 la@lBlDllll\mmmDnFn{{yVyVyVyVyVyVyVh{$$7$8$H$Ifa$gd[R$$7$8$H$Ifa$gd$$If`a$gd[Rekd"!$$IflFh* t    44 la FnPoRoToVo\ooooooooooooooƱ~rcPcP?Pc3ch-CJ OJQJaJ !hbFCJ OJQJaJ mHnHu%jhf(hf(CJ OJQJUaJ hf(hf(CJ OJQJaJ hQCJ OJQJaJ h"KCJ OJQJaJ hf(hZCJ OJQJaJ h,UCJ OJQJaJ hnCJ OJQJaJ )h7'Hh7'HB*CJOJQJ^JaJphhCJOJQJ^JaJ)hhB*CJOJQJ^JaJph,hh5B*CJOJQJ^JaJphFnRoToVoooooop$pTpVp{%0*V~0*i~0*i~0*i||tVtVtV|$a$gdZ-gdf( 7$8$H$gd,Uekd!$$IflFh* t    44 la $7$8$H$Ifgd ooopTpVpvpppppѼ)h7'Hh7'HB*CJOJQJ^JaJphhXhZ-hH^:hZ-CJOJQJaJhH^:hZ-5CJOJQJaJh4P5hZ VpvppppppVVV0*V 7$8$H$gd,UgdZ-&1h:p7'H/ =!"#$%nJpbQ9PNG  IHDR8-gAMAPLTEU~OIDATxO+q{!+r>t 䐣@?| ,$^^rp/`C;`y!vC@fgRU=3$t q| *ɿɾ 3j ~ 5`Q*飣+MӣݦK#n pqIDrhe젩yXb(icCI e-mlUk {`H]5m-fޢ2'O6jˋr^{z%GӴjq8P1O!u"ސt۶ӻ TоW حO"y%}o!k{4mA{ٟ܎dGG;xCu 0;FKj=d6t3";:zk\ Xָ+how{JgҳwfD8<}oH@ш#0xaꎺ#SG :h]JSA_} ͩCZrzOin)FyTrkRK$ ^ v"ZPZn&Z$y:#)JO:m+cZh@ I7&VL ;RDC u{@ h!!ÂL?mYc:NY5ym`b`zKv:QBfKl-lOdtXh?.Z[ V[^Yrܞ џOd5!T *a"K"2 Jᾇgrn.9%K^ _gR@oG<.7Xu-jݮR}zeq|(.7mn$?C=9pn(%GI5H8=ilh>X#1C͜܆ zy7H;^s@x.;cT3 )h;,'f6'D}-,TsҠ QNžu0w+/kN*nT)2pځDu&hC]6OYTD0e5; E ,qלEz7H"z%=8{)dr;lg[.JrQaOVX'v z%:"><25$k.G4S`DN8L9qDhj>p)Yɑ,9 ]F%o|6R{ƫLe7l.Ox.ؙ+NjI˾iisMs~8\.ԝ/P}} d|^z8_h.RLfW+X'Rfu$Y3l,Ǹ i 8=04XS:+Օȗ"+T+L->V[t sQW43R*У>.j=+WWwrjA:Tsih*&,dmXAsM\6b 4Bf6`*RR3-tɩ#\2pM37-HPRyu``W&9$FI.@FK͑8H-a|9Fylr)cΘ;wH&-%gvO\lfVifK2K4/ ##Mj?,TOC{{$zy s,:ު q`@ ,JK.fgd7\O=jA9#RsēfxFj_sv0`~ffJn>R-d,B'sŃ7AkHyU<]>pFI-f)sYKnD> qN3$\,H=ODtM6"|qő AkXhf rM;$/rZ[*3?ư fQ]VfpCՈ #K\4~U;0Tq"C9Fm>2#k+0p]1Bu!yپp٦ 23.$uYrh칚286$s;5[CEM\s?ʨR^5}pQ>xeXȸPvD\1wn05eO"pGb9Ŕ&# ߘ=737k4ppյX72isn4'J6p]D͟\(n\h\$G7K¸qh).e&/k#W]#G/9u% =hKKc=D+n&ܷ|&zzp A8sd!t{X~O78Ur߲Eɱ\M0A(Z% M$s;hrY [p^4(#%Mx䚷ɚ:pU~ S_RL" r_2dWrmcnɩEw?Wp}eWr@ZrYr759';!;RSI7ymBtMW/^ط_}e1w߉7yvyC%ת(h\ȟ_a=%oBUq&yxK+rrk/CD̑ʪAf{# ;9 LA!+OOOk9s^/̧ʾ^Oo%D8_[\{jTe[UF ׯܦ>L`@_ܑ\q5`LS,~=/qI(h D-enrпos83 &;ir/8+K0f`%=EP! #NSO}A0 1T5dQUmna%9;ï.?E#GpsLS ]rG4瓓!ϩ= VEGQ>D~Q=(\$wmlp)np]~k$ l9ffzCBYq1&鳒Sz2[d~USK߳h^;!4w缁557%n'Bk*'n*)18"!r+|sh츲iR̹˕G==߳jqw#i8.OP]T[Cw=|- 3`l5'4-Ȭ'iOJ|u/:5"Cl]ޮ9ة _9t31جcټH&^4q3RIS7wp-HSjK*jCCAP%SGf|LJ !9M%,. 3ԔTnXBNRA4: ,L~t#)LEqzDQ@Tg'}B0A +s=cOW|'Z؞Ŝ:V,"YWДxL |B_̡ի!@ܾWYCזh]¼=U1Ё JnC1y9*l1š.c}U?ެB\PODf`͝\)OVGj6\>-2q%1CՈ*CG:J]Æ zڡ(:6Ѐᆏ[K*jp4xknB>A?JWG""&]bBN*.Wّ"QN|JGK8Bj2Wn r@);niu$ 죆&HS=6IYFQyl*uAU`G`Ap>(vĺ6S\ť]4: t-ZYB9IYesb49k~(qon}. M/|>Ւ-ѯ= k͇GghnZAߣxut\me6x h#p1Τe>SE:qUB|l 3O9O5!(Iv@HTuQ܈OqyGd&+.c5y6$:8ם)>DQj<(ujP1%y,wPPW*"{]p|Z-RU⟬W)7SY*# tz 2ۓh01d\c WZ/Ϸ  *pgL.!KS:\&pa79UZ`zliCM.zan]P嚰[F\^OA1}_>6 fAfmRLiXvAqv!Ayo!mVKJ/dw 6RhC4D+E [j!wBY(V Ϫ]/= ޫ7|ҽ{O+}uPpP mVi{"ݺxAw/͐7:֐ ٺA{sÍ uc.uǨ{ťo W[J]]9>/F6,:/￟ k]>1wy]Ap:u"8M=taTAGEy% \AJ_ŠI)#7xcޮv$`ALP{p/k67i55@Bz Z-TitleL$$d %d &d 'd N O P Q a$ 5CJ \6U@Q6 Z- Hyperlink >*B*ph.X@a. Z-Emphasis6]j@sj 1 Table Grid7:V0`O` 7'HQuick 1.7$8$H$`!B*CJ_HaJmH phsH tH :qd :qtd  zd 9k%&"#$%&'*On()*+,@ABCDEH./0DXlmnyz { | } ~      ! " D { | " #  * + ; I a b e 00p000000x0000p0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0X 0X0X 0 0X 0\ 0X 0X 0 0X 0\ 0X 0X 0 0X 0\ 0X 0X 0\ 0X 0X0X 0 0X 0\ 0X 0X 0 0X 0\ 0X 0X 0 0X 0\ 0X 0X 0\ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0X 0X 0 0\ 0X 0X 0 0\ 0X 0X 0 0\ 0X 0X 0\ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00000000 0 0 00@00@00H00000H0000i9%&"%&'*nCDEH./yz {   ! " # e 000000000@0`:00z00 z00xF z00xF#@0d@0z00S@0@0z00z00z00z00z00z00@0dz0 0z0 0z00z0$0z0$0@0dz0'0z0%0z0'0z0+0z0+0@0dz0.0z0.0@0`z030W@0dz050z050@0z030@0dz010Hl@0dz060z040z0;0`Xz040z060z040z0D0\Yz00 z00 @0d z00z00@0` z00Hݒ@0z00z00z00@0 z00HDޒz00z00Hz00z00@0z00z00@0 0EEEH n d BdjFnop !%'*.1:>@j x F L  6 f l "PX\THv|jk8l@lFnVpp  "#$&()+,-/0239;<=?Ap  nz &,8>0<BDPVXdjnzy d XFFFFFFFFFFFFFFFFFFFFFF4;=H!l,b$JpbQ9(@|(  |  S LAI.`US`TUS`T\  3 "` \  3 "` B S  ?kld tX s0*Cts CtText1Text2Text3Text4Text5Text6Text7Text8Text9Text12Text15Text10Text13Text16Text11Text14Text17Text22Text19Text20Text21Text18o-1EYoz e  !'?CWk e ŊƊ<?ƊA@Ɗ<AƊtBƊTJ 11' '     ; ; I I S V e      ??  5 5     ) ) C H Q U ` ` e   V*urn:schemas-microsoft-com:office:smarttagsplacehttp://www.5iantlavalamp.com/: *urn:schemas-microsoft-com:office:smarttagsStreet>*urn:schemas-microsoft-com:office:smarttags PostalCode9*urn:schemas-microsoft-com:office:smarttagsState8 *urn:schemas-microsoft-com:office:smarttagsCity; *urn:schemas-microsoft-com:office:smarttagsaddress      e  e a!"$''NlnB0CDWXkn..y~ ~   ! ! e  e *ovh9.g?;"d+1W(v`utFp= zpv hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.^`o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.^`o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH. 88^8`5o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH. ^`5o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h9.?;utFp zd+1W*o                                                     <;(1X@v &Ar"e'f(*)Q)-P/u13144P5-S9bF7'H I)J*J"Kk PSAVXZFag.i5zjn{qCrw_3{||}M/m%SKZ-[R'=ijQn5O x,UTMeP: 5&"#$%&'*n()*+,@ABCDEH./0DXlmnyz { | } ~      ! " # e @ ]fdd @ hUnknownGz Times New Roman5Symbol3& z Arial7&  VerdanaK,Bookman Old Style"hZZjF  !r4d 3QH(?jS Anna Albers Anna Albers$      Oh+'0   < H T `lt|Sss Anna Albersnnannasupplemental_form_c Anna Albers3naMicrosoft Word 10.0@F#@rqh@z&=S&@@[T& ՜.+,D՜.+,L hp  $S.C. Department of Consumer Affairs : S Title 8@ _PID_HLINKSAp!+http://www.scconsumer.gov/  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLNOPQRSTUVWXYZ[\]^`abcdefghijklmnopqrstuvwxyz{|}~Root Entry F\T&Data MV"1Table_8OWordDocumentSummaryInformation(DocumentSummaryInformation8CompObjj  FMicrosoft Word Document MSWordDocWord.Document.89q