No Form number Application for Additional Base (Class 1 - Scotch--exist

OMS No. 0581-0178

FAR WEST SPEARMINT OIL ADMINISTRATIVE

COMMITTEE

100 North FrullJand, Suite 8
Kenn9Wk:lc, WA 99336
(509) 585-5460

Application For Additional Base
CLASS 1 (SCOTCH.

Pursuant to Sec:tion 985. 153 0-2, I hereby request that the approplal6
base be Issued

to me effecthIe

quantity

of additional

June 1, 20.-.

Add/tJonai

Base

Will Be Added To:

Signed
OMBII 0581-0178

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