[3]104-10100-10239—™
[10]reo Luts cifta, Fis BE 4, ET, APY _
[11]it) BAVE : . oo 22 Th, a _ en ~
[13]ww MEXI a . ~
[14]a So , ; Se, 7 eee
[15]TYPIC ae oS a ,
[16]nee pir 4@67Y
[18]a ; OG
[20]os IDEN IS[HMICHEL CHIDIAC, LEBANES
[22]| > MEXI. 5954 /1D 6008 FOR RECENT TRAVEL.
[24]RL CHARGE 18 HAVARA. Sku
[26]RETURN TO CIA
[27]round Use Only
[28]-DoNot Reproduce
[29]- gag/uon fo Dorling (ta draft) ©.