rowid,Short_Form_Termination_Date,Short_Form_Date,Short_Form_Last_Name,Short_Form_First_Name,Registration_Number,Registration_Date,Registrant_Name,Address_1,Address_2,City,State,Zip 10731,1966-03-25,1966-03-25,Barrella,Romeo,1972,1966-03-25,Haiti Government Tourist Bureau,600 South Michigan Boulevard,,Chicago,IL,60605