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        <StateAbbreviationCd>WA</StateAbbreviationCd>
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      <PhoneNum>8773288771</PhoneNum>
      <USAddress>
        <AddressLine1Txt>PO Box 517</AddressLine1Txt>
        <CityNm>RAVENSDALE</CityNm>
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        <ZIPCd>98051</ZIPCd>
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      <PersonNm>Robin Leick</PersonNm>
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      <PreparerPersonNm>Linda Oliveira</PreparerPersonNm>
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      <PreparationDt>2018-01-15</PreparationDt>
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        <PersonNm>Amy DeVore</PersonNm>
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        <PersonNm>Liz Anderson</PersonNm>
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