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
36749,1991-11-30,1987-09-15,Allen,Charles E.,1991,1967-11-06,"Philip Van Slyck, Inc.",17 East 45th Street,Suite 406,New York,NY,10017