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f <br /> Rev 2/23/2001 <br /> Page G of G <br /> t Pr sparer presents th to the best of die Preparer's knowledge the above statements and facts are <br /> true and orr ct and the best of the Preparer's actual knowledge no material facts have been <br /> suppress <br /> User's Signature 3 t Dat <br /> Preparer's Signature (( Date <br /> e <br /> Respondant's Signature Date <br /> i, <br /> dO <br /> ; t <br /> _ <br /> U TormsWield FornislESA\Transaction Screen Questwnaire doc <br /> r <br /> Initials <br />