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break party
2017
Windows On The Water
931 Ocean Avenue,
Sea Bright, NJ
Thursday, April 27, 2017
6:00PM- 9:00PM
NEW THIS YEAR OPEN BAR!
SPONSORED BY
EĂŵĞͬ ĞƐŝŐŶĂƟŽŶ͗___________________________________
ŽŵƉĂŶLJ EĂŵĞ͗ _____________________________________
ĚĚƌĞƐƐ͗ ___________________________________________
ŝƚLJ͕ ^ƚĂƚĞ͕ ŝƉ͗ ______________________________________
WŚŽŶĞ͗ ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ &Ădž͗__________________
ŵĂŝů͗______________________________________________
ͺͺͺͺͺͺ dŝĐŬĞƚƐ ;ƉĞƌ ƉĞƌƐŽŶͿ ^ĞĞ ďĞůŽǁ ĨŽƌ ƉƌŝĐŝŶŐ͗
EŽƚĞ͗ hůƟŵĂƚĞ WĂƌƚŶĞƌƐ ƌĞĐĞŝǀĞ ϰ ƟĐŬĞƚƐ͘ ůŝƚĞ WĂƌƚŶĞƌƐ
Ϯ ƟĐŬĞƚƐ͘ WƌĞŵŝĞƌ WĂƌƚŶĞƌƐ ƌĞĐĞŝǀĞ ϭ ƟĐŬĞƚ͘
ZĞŐŝƐƚĞƌ ďLJ͗
ϰͬϳ
ŌĞƌ ϰͬϳ Žƌ KŶƐŝƚĞ
/ͲE: DĞŵďĞƌƐ͗
ΨϭϬϱ
Ψϭϭϱ
EŽŶͲDĞŵďĞƌƐ͗
ΨϭϮϱ
Ψϭϯϱ
WůĞĂƐĞ ůŝƐƚ ƚŚĞ ŶĂŵĞ͕ ĐŽŵƉĂŶLJ ĂŶĚ ĚĞƐŝŐŶĂƟŽŶƐ ŽĨ ĂĚĚŝƟŽŶĂů
registrants.
Ϯ͘ _________________________________________________
ϯ͘ _________________________________________________
4. _________________________________________________
dKd >͗ Ψͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
WĂLJŵĞŶƚ DĞƚŚŽĚƐ͗
ϭ͘ WĂLJ ďLJ ĐŚĞĐŬ͕ ƉĂLJĂďůĞ ƚŽ /ͲE:͘ DĂŝů ĐŽŵƉůĞƚĞĚ ĨŽƌŵ ĂŶĚ
ƉĂLJŵĞŶƚ ƚŽ͗
/ͲE:͕ ƩŶ͗ ϮϬϭϳ ^ƉƌŝŶŐ ƌĞĂŬ WĂƌƚLJ͕ ϱϬϬ ,ĂƌĚŝŶŐ
ZŽĂĚ͕ &ƌĞĞŚŽůĚ͕ E: ϬϳϳϮϴ
Ϯ͘ WĂLJ ďLJ ĐƌĞĚŝƚ ĐĂƌĚ͗
ĂƌĚŚŽůĚĞƌ EĂŵĞ͗ ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ĂƌĚ EƵŵďĞƌ͗ _______________________________________
džƉ͘ ĂƚĞ͗ __________________________________________
^ĞĐƵƌŝƚLJ ŽĚĞ͗ _______________________________________
ĂƌĚŚŽůĚĞƌ ^ŝŐŶĂƚƵƌĞ͗ ________________________________
Ύ ĂƌĚŚŽůĚĞƌ ĂĐŬŶŽǁůĞĚŐĞƐ ƌĞĐĞŝƉƚ ŽĨ ŐŽŽĚƐ ĂŶĚͬŽƌ ƐĞƌǀŝĐĞƐ ŝŶ
ƚŚĞ ĂŵŽƵŶƚ ŽĨ ƚŚĞ ƚŽƚĂů ƐŚŽǁŶ ŚĞƌĞŽŶ ĂŶĚ ĂŐƌĞĞƐ ƚŽ ƉĞƌĨŽƌŵ
ƚŚĞ ŽďůŝŐĂƟŽŶƐ ƐĞƚ ĨŽƌƚŚ ŝŶ ƚŚĞ ĐĂƌĚŚŽůĚĞƌ͛Ɛ ĂŐƌĞĞŵĞŶƚ ǁŝƚŚ
issuer.
&Žƌ ŵŽƌĞ ŝŶĨŽƌŵĂƟŽŶ Žƌ ƚŽ ƐƵŵďŝƚ ƌĞŐŝƐƚƌĂƟŽŶ͕ ĐŽŶƚĂĐƚ
ũĂĐůLJŶΛĐĂŝŶũ͘ŽƌŐ Žƌ ĨĂdž ;ϲϬϵͿ ϱϴϴͲϬϬϰϬ͘
ĂŶĐĞůůĂƟŽŶƐͬ ZĞĨƵŶĚƐ ǁŝůů ŶŽƚ ďĞ ĂĐĐĞƉƚĞĚ ĂŌĞƌ Ɖƌŝů ϮϬ͕ ϮϬϭϳ͘ ^ǁĂƉƐ ĐĂŶ ďĞ ŵĂĚĞ Ăƚ ĂŶLJ ƟŵĞ͘