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e — @ | MONTHLY INCOME PLAINTIFF/PETITIONER'S MONTHLY INCOME; SOURCES AND BILL(S) 1-Pension: Veterans Administration(War) Monthly $300.00 2-Supplement Social Security Monthly $422.00 Total $722.00 BILLS I~Rent Monthly $207.00 2-First North American National Bank Monthly $.78.00 3-Capital Bank Monthly $100.00 4-Dillard Bank Monthly $ 79.00 5-Veterans Life Insurance Monthly $ 22.45 6-United of Omaha Insurance Co. Monthly $ 15.00 7-South West Bill Telephone Co. Monthly $ 29.00 ? 8-Mercantile Bank Monthly 7.00 9-Sweeptakes Clearinghouse(Lay A Way) Monthly 10.00 10-Over the Counter Medications Monthly e.g.,Zantac~75;Mylanta Maximum Strength; Vitamins-E,C,B6,B12, A&D; and Zinc,approximately $ 58.00 11-Food approximately $100.00 12 TOTAL $705.45 I,Sylvester Jones over the age of 21,Swear pursuant to Title 28 USC § 1746,that the above statement,are true,correct,and accurate to the best of my knowledge,understanding,and beli-. eve SO HELP ME GOD: EXECUTED ON THIS vale, APPENDIX—< 5