November 2019 Newsletter
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
410-939-3170<br />
8 North Earlton Road, Ext<br />
Havre de Grace, MD 21078<br />
admin@templeadasshalom.org<br />
Page 2-3<br />
Page 4<br />
Page 5<br />
Page 5<br />
Page 6<br />
Page 7<br />
Page 8<br />
Page 9<br />
Page 10<br />
Page 11<br />
Page 12<br />
Page 13<br />
Page 14<br />
Page 15<br />
Page 16<br />
Page 16<br />
Page 17<br />
Page 17-18<br />
Page 18<br />
Page 19<br />
Page 19<br />
Page 20-22<br />
<strong>November</strong> <strong>2019</strong> Calendar of Events<br />
Rabbi’s Message<br />
Religious Practices Message - Mark Wolkow & Melissa Brown<br />
Mazel Tov Announcements<br />
Qualified Charitable Donations<br />
Dough for Funds Fundraiser<br />
Sisterhood News - Elise Woods<br />
Tree of Life Order Form<br />
Family Game & Movie Night - <strong>November</strong> 9 th<br />
Sisterhood Member Appreciation Dinner - <strong>November</strong> 12 th<br />
Senior Meet & Greet with Rabbi Franken - <strong>November</strong> 15 th<br />
Congregational Meeting & Breakfast - <strong>November</strong> 17 th<br />
Mahjongg Night - <strong>November</strong> 19 th<br />
<strong>November</strong> <strong>2019</strong> Daven & Dine - <strong>November</strong> 22 nd<br />
Gift Shop News - Pat Wolkow & Denise Gordon<br />
Security Committee - Pat Wolkow<br />
Nominating Committee - Charna Kinneberg<br />
Special Thanks to Our Monthly Donors<br />
Mi Sheberakh List - We Pray For Healing<br />
Recently Passed<br />
<strong>November</strong> <strong>2019</strong> Yahrzeits Observed<br />
Advertising
Temple Adas Shalom’s <strong>November</strong> <strong>2019</strong> Calendar of Events<br />
Sunday Monday Tuesday Wednesday<br />
3 5 th of Heshvan 5780<br />
Fall Back - DST Ends<br />
9:00-12:15 pm - Gift Shop<br />
9:00-12:00 pm - Kehillah<br />
MAGNET<br />
4 6 th of Heshvan 5780<br />
HJC-ELC Closed<br />
7:00-8:00 pm - Al-Anon Mtg<br />
(Social Hall)<br />
5 7 th of Heshvan 5780<br />
State Election Day<br />
6 8 th of Heshvan 5780<br />
7:30 pm - Choir Rehearsal<br />
(Mike’s Home)<br />
10 12 th of Heshvan 5780<br />
9:00-12:15 pm - Gift Shop<br />
9:00-12:00 pm - Kehillah<br />
MAGNET<br />
12:00 pm - Private Event in the<br />
Social Hall<br />
11 13 th of Heshvan 5780<br />
Veteran’s Day<br />
HJC-ELC Closed<br />
7:00-8:00 pm - Al-Anon Mtg<br />
(Social Hall)<br />
12 14 th of Heshvan 5780<br />
12:15 pm - Sisterhood Member<br />
Appreciation Dinner<br />
**RSVP by <strong>November</strong> 7 th to Pat<br />
Wolkow**<br />
13 15 th of Heshvan 5780<br />
17 19 th of Heshvan 5780<br />
18 20 th of Heshvan 5780<br />
19 21 st of Heshvan 5780<br />
20 22 nd of Heshvan 5780<br />
9:00-12:15 pm - Gift Shop<br />
9:00-12:00 pm - Kehillah<br />
MAGNET<br />
9:00 am - Congregational<br />
Meeting<br />
7:00-8:00 pm - Al-Anon Mtg<br />
(Social Hall)<br />
7:00 pm - Mahjongg Group<br />
7:30 pm - Choir Rehearsal<br />
(Mike’s Home)<br />
24 26 th of Heshvan 5780<br />
9:00-12:15 pm - Gift Shop<br />
9:00-12:00 pm - Kehillah<br />
MAGNET<br />
25 27 th of Heshvan 5780<br />
7:00-8:00 pm - Al-Anon Mtg<br />
(Social Hall)<br />
26 28 th of Heshvan 5780<br />
7:00 pm - RPC Meeting<br />
27 29 th of Heshvan 5780<br />
HJC-ELC Closed<br />
2 | P a g e
Temple Adas Shalom’s <strong>November</strong> <strong>2019</strong> Calendar of Events<br />
Thursday Friday Saturday<br />
1 3 rd of Heshvan 5780<br />
HJC-ELC Half Day B<br />
5:44 pm - Candle Lighting<br />
5:15-6:45 pm - Gift Shop<br />
5:30-8:00 pm - Friday Night Kehillah<br />
MAGNET<br />
7:00 pm - Eye Level Torah Service<br />
Rabbi John Franken<br />
ONEG - L. Feulner, C. Kinneberg<br />
2 4 th of Heshvan 5780<br />
Parashat Noach<br />
7 9 th of Heshvan 5780<br />
7:00 pm - Board Meeting<br />
8 10 th of Heshvan 5780<br />
4:37 pm - Candle Lighting<br />
6:00 pm - Torah Service<br />
ASTY & Rabbi John Franken<br />
ONEG - C. Chalmin, L. Bress<br />
9 11 th of Heshvan 5780<br />
Parashat Lech-Lecha<br />
6:45-9:45 pm - Temple Adas Shalom<br />
Family Game & Movie Night<br />
(Free Event for all Members & Friends of<br />
TAS)<br />
14 16 th of Heshvan 5780 15 17 th of Heshvan 5780<br />
4:31 pm - Candle Lighting<br />
5:15-6:45 pm - Gift Shop<br />
5:30-8:00 pm - Friday Night Kehillah<br />
MAGNET<br />
7:00 pm - Friday Night Shabbat Service<br />
with the TAS Choir Singing<br />
Rabbi John Franken<br />
ONEG - C. Kinneberg, J. Klein<br />
16 18 th of Heshvan 5780<br />
Parashat Vayera<br />
21 23 rd of Heshvan 5780 22 24 th of Heshvan 5780<br />
4:26 pm - Candle Lighting<br />
6:00 pm - Daven & Dine Shabbat Service<br />
with the TAS Choir Singing<br />
Rabbi John Franken<br />
DINE - Miller’s Ale House in Bel Air, MD<br />
23 25 th of Heshvan 5780<br />
Parashat Chayei Sara<br />
10:00-11:30 am - Taking Hold of the Torah<br />
Rabbi John Franken<br />
28 30 th of Heshvan 5780<br />
Thanksgiving Day<br />
Office & HJC-ELC Closed<br />
29 1 st of Kislev 5780<br />
Office & HJC-ELC Closed<br />
4:23 pm - Candle Lighting<br />
7:00 pm - Shabbat Service with the TAS<br />
Choir Singing<br />
Rabbi Gila Ruskin, Tony Herrin, and George<br />
Herrin<br />
ONEG - B’nai Mitzvah Class<br />
30 2 nd of Kislev 5780<br />
Parashat Toldot<br />
10:00-12:15 pm - Tony & George Herrin<br />
B’nai Mitzvah & Torah Service<br />
Rabbi Gila Ruskin, Tony Herrin, and George<br />
Herrin<br />
3 | P a g e
Rabbi’s Message<br />
Rabbi John Franken<br />
Dear Friends:<br />
A sage once declared that every person should say 100 blessings a day. 100 blessings? To<br />
many of us that would seem beyond reach when identifying, much less blessing, our<br />
good fortune comes neither easily nor naturally. For this reason, perhaps, the Rabbis<br />
filled our prayer book liturgy with blessings, or praises to God, for the gifts we<br />
otherwise might take for granted.<br />
In the morning service alone, we praise God for the wonder of creation, for the gift of<br />
love through Torah, for the marvel of the human body, for the purity of our souls, for<br />
making us in God’s image, for making us Jews, for making us free, for enlightening the<br />
unenlightened, for giving strength to the weary, for freeing the captive, for being the<br />
Source of Peace.<br />
These blessings are blessings ben adam laMakom – between humans and the Holy<br />
One. Yet there are also blessings we say ben adam lachavero – between one person and<br />
another. In our daily lives, “Good morning” or “Have a good day” are blessings in the<br />
same way “Shalom” or “Shalom Aleichem” (“Peace be upon you”) are. They are words of<br />
kindness and goodness whose utterance brings out our love of God and humanity. In<br />
my travels I have encountered foreigners who make fun of Americans for routinely<br />
saying “Have a nice day.” Evidently they cannot imagine strangers really caring whether<br />
others have a nice day or not. But blessing someone else with a pleasant day brings a<br />
certain goodness and goodwill into the world that touches all of us—the speaker as<br />
well as the recipient.<br />
In our tradition, besides routine blessings, there are also extraordinary ones. After<br />
being welcomed to a new place (“Baruch haba”), for example, one customarily replies<br />
“Baruch hanimtza.” Colloquially, the reply means something like “right back at you” but it<br />
can also mean “I am blessed to be here.” Such is how I feel about coming to Adas<br />
Shalom to be your new rabbi. It is a joy, a privilege and an honor, but mostly it is a<br />
blessing. I look forward to sharing our lives together and hope very much you will<br />
come by to introduce yourself. So let me say, after receiving such a warm welcome since<br />
my arrival a few weeks ago, “Baruch hanimtza.” It is a blessing to be among you.<br />
4 | P a g e
Religious Practices Message<br />
Mark Wolkow & Melissa Brown<br />
Happy Thanksgiving from the Religious Practices Committee!<br />
The main theme of Thanksgiving comes from the name itself, reminding<br />
us of the importance of giving thanks. When a Jew sits down to eat, he or<br />
she says: "Blessed are you God, for bringing bread from the earth." To say<br />
a blessing over bread affirms that God played a role in providing for our<br />
needs by creating a universe where the sun rises each day and the rain<br />
falls, making the growth of food possible.<br />
The RPC is thankful for Rabbi Gila's many years of inspiration, creativity<br />
and dedication to serving our community. As we say our farewells to<br />
Rabbi Gila, we also look forward to our future with Rabbi John Franken.<br />
A new rabbi brings new ideas, new music, new programs, new attitudes<br />
and new answers to old questions. We encourage you to come out in the<br />
upcoming weeks and months to get to know Rabbi Franken as he leads<br />
us in meaningful and spiritual Shabbat services and begins to get to<br />
know all of us.<br />
Our Daven & Dine service this month is on <strong>November</strong> 22. It begins at<br />
6:00 PM and ends at 6:45 - then dinner out with friends and family!<br />
We look forward to celebrating the B'nai Mitzvah of George and Tony<br />
Herrin on <strong>November</strong> 29 and 30.<br />
See you in shul!<br />
Mark & Melissa<br />
Mazel Tov<br />
Mazel Tov to Marjorie & Roger Sherman on the marriage of their<br />
daughter Anna Sherman.<br />
5 | P a g e
Qualified Charitable Donations<br />
The end of the year is quickly coming and many of us use this time of year to make lastminute<br />
donations for the year. Here is a brief excerpt from a Fidelity article, “Qualified<br />
Charitable Deductions (QCD),” which might be something to think about if you are<br />
retired and have some money left to meet your Required Minimum Distribution for the<br />
year.<br />
A Qualified Charitable Deduction (QCD) is a direct transfer of funds from your IRA<br />
custodian, payable to a qualified charity. QCDs can be counted toward satisfying<br />
your required minimum distributions for the year, as long as certain rules are met.<br />
In addition to the benefits of giving to charity, a QCD excludes the amount donated<br />
from taxable income, which is unlike regular withdrawals from an IRA. Keeping<br />
your taxable income lower may reduce the impact to certain tax credits and<br />
deductions, including Social Security and Medicare.<br />
Also, QCDs don't require that you itemize, which due to the recent tax law changes,<br />
means you may decide to take advantage of the higher standard deduction, but still<br />
use a QCD for charitable giving.<br />
Can I make a QCD?<br />
While many IRAs are eligible for QCDs—Traditional, Rollover, Inherited, and, for<br />
inactive plans, SEP and SIMPLE—there are requirements:<br />
<br />
<br />
<br />
<br />
You must be 70½ or older to be eligible to make a QCD.<br />
QCDs are limited to the amount that would otherwise be taxed as ordinary income. This<br />
excludes non-deductible contributions.<br />
The maximum annual amount that can qualify for a QCD is $100,000. This applies to the<br />
sum of QCDs made to one or more charities in a calendar year. If, however, you file taxes<br />
jointly, your spouse can also make a QCD from his or her own IRA within the same tax year<br />
for up to $100,000.<br />
For a QCD to count towards your current year's RMD, the funds must come out of your<br />
IRA by your RMD deadline, generally December 31.<br />
The temple is pushing to match the generous donation from David Schwaber and retire<br />
the building debt. A QCD would be a great way to help us accomplish this goal. If you<br />
are interested, I would encourage you to speak with your financial advisor.<br />
Thank you.<br />
6 | P a g e
7 | P a g e
Sisterhood Greetings<br />
Elise Woods<br />
Greetings from the Sisterhood!<br />
This month, the Sisterhood invites you to its Member Appreciation<br />
Dinner on Tuesday, <strong>November</strong> 12, at 6:30 PM in the Social Hall. Join us<br />
as we share a wonderful evening of great food and fellowship. We have<br />
invited Rabbi Franken to join us and share his perspectives as he joins<br />
our congregation. Please RSVP no later then <strong>November</strong> 7. If you haven’t<br />
yet paid your Sisterhood dues or are still undecided about joining, it is no<br />
problem. Please join us anyway and see what we are all about. If you<br />
would like to pay your yearly dues of $42 that evening, we will be<br />
available to collect it as well.<br />
We are currently accepting applications for summer camp assistance<br />
scholarships. As many of you know, the Sisterhood supports families<br />
financially by providing scholarships for our youth to attend Jewish<br />
summer camp. Blank applications will be left in the Sisterhood mailbox.<br />
If you haven’t already done so and have an interest in applying, please<br />
submit your application to me by <strong>November</strong> 15, <strong>2019</strong>. Recipients of the<br />
scholarships will be notified in December.<br />
As a reminder, the Sisterhood sponsors the Tree of Life sculpture in the<br />
synagogue lobby. Please contact me for a flyer that can be used to order<br />
leaves that may be inscribed to highlight or commemorate joyous events<br />
like births, weddings, anniversaries, graduations, Confirmations, Bar and<br />
Bat Mitzvahs, or to honor parents, family and friends. Please consider<br />
inscribing a leaf for your next special event. Your memories will endure<br />
in our synagogue for a lifetime!<br />
Elise Woods<br />
President<br />
8 | P a g e
9 | P a g e
10 | P a g e
11 | P a g e
12 | P a g e
13 | P a g e
14 | P a g e
15 | P a g e
Gift Shop Announcements<br />
Pat Wolkow & Denise Gordon<br />
Chanukah items are popping up in the Gift Shop. Start making your list<br />
and stop in for a look.<br />
The big shopping day for our students will be December 8. We are<br />
offering to gift wrap their purchases this year for a very nominal cost.<br />
We are looking for volunteers to become trained to work hours in the<br />
gift shop. We also need someone to help with creating on-line product<br />
pages. Please contact Pat Wolkow about training.<br />
If you are shopping for Judaica on-line, we can usually match the price<br />
offered or even purchase for less because of wholesale pricing. If you plan<br />
to shop ahead of time for your needs, or wish to support your Sisterhood,<br />
who in turn supports our Congregation, then give us a shout!<br />
Pat Wolkow & Denise Gordon<br />
Security Committee Information<br />
Pat Wolkow<br />
Your team is currently working on another grant to fund more security<br />
hardening to the building and help with security personnel costs. These<br />
grants, we hope, will allow us to avoid adding a “Security Fee” to our<br />
membership dues statements, which many congregations have had to do!<br />
In January we have scheduled security training and planning for temple<br />
leadership and teachers. In this training we will learn how to best<br />
prepare for emergencies through developing a plan of action. We will<br />
also offer, for those who have not been trained, “Stop the Bleed” and CPR<br />
training.<br />
Anyone interested in joining our team, please contact Pat Wolkow.<br />
16 | P a g e
Nominating Committee<br />
Charna Kinneberg<br />
The Nominating Committee is proposing the following slate of officers<br />
to be elected in <strong>November</strong> <strong>2019</strong> for their term starting June 2020. Please<br />
note that these are the open positions only.<br />
<br />
<br />
<br />
<br />
Trustee - Adult Education: Stephen Marksamer<br />
Trustee - Caring Committee: Carol Mohr<br />
Trustee - Fundraising: Terry Weiner<br />
Trustee – Social: Mike Gordon<br />
We continue to have an opening at this point for President. If anyone is<br />
willing to fill this important position, please contact me at 443-243-1711.<br />
Thank you.<br />
Charna Kinneberg<br />
Kevin & Lisa Bress<br />
Cheryl & Jeffery Conley<br />
Wendy & Patrick Drabinski<br />
Andrew & Marianne Fridberg<br />
Carol & Sigmund Gast<br />
Phillip & Barbara Gilden<br />
Arthur & Denise Gordon<br />
Michael Gordon<br />
Richard Hoffman<br />
Melissa Immel<br />
Kathleen & Michael Lazarski<br />
Barbara & Natalie Litofsky<br />
Paula Mathai<br />
Carol Mohr & David Brown<br />
Linda & Stuart Needel<br />
Ashiq & Ashira Quabili<br />
Rayna & David Richardson<br />
Jeffrey & Francene Cohen<br />
Debbie Rose Delaney<br />
Sam Meyer & Ms. Pam Gwaltney<br />
Paula Mullis<br />
Eve Pardo<br />
17 | P a g e<br />
September <strong>2019</strong> – Donors<br />
BUILDING FUND<br />
Julie Sang<br />
Jeffrey & Amy Schoenberger<br />
Jill & Brian Schorr<br />
William & Kristi Schwartz<br />
Eric & Anne Seeley<br />
Brett & Debbie Temple<br />
Jonas & Paula Vogelhut<br />
Naomi Walton<br />
Robin & Mark Way<br />
Mark & Patricia Wolkow<br />
Selma Wolkow<br />
Elise & Michael Woods<br />
Jill & Daniel Young<br />
Richard and Rhonda August<br />
Seth and Brooke Grossman<br />
Judith Armstrong & Francine Hawes<br />
L'dor Vador<br />
In memory of Andy Klein<br />
L'dor Vador<br />
L'dor Vador<br />
In honor of the Niall O'Donnell family
September <strong>2019</strong> – Donors<br />
BOOK OF REMEMBRANCE<br />
Debbie Rose Delaney<br />
Paula Mullis<br />
Leila Diamant<br />
Nancy Natkin<br />
Ellen & Ken Farkas<br />
Gregory & Felice Repas<br />
Robyn & Randy Florio<br />
Irwin Rosenfeld<br />
Adele Friedman<br />
Stan Rovine<br />
Phillip & Barbara Gilden<br />
Julie Sang<br />
Arthur & Denise Gordon<br />
Zita Schneck<br />
Marie Grove<br />
David & Alena Schwaber<br />
Hindy Kempler<br />
Sandy Schwartz<br />
Robert & Charna Kinneberg<br />
Brett & Debbie Temple<br />
Paul & Nancy Lever<br />
Martin & Marcy Werde<br />
Stephen & Patricia Marksamer<br />
Mark & Patricia Wolkow<br />
Carol Mohr & David Brown<br />
Selma Wolkow<br />
ELC SCHOLARSHIP FUND<br />
Jeffrey & Amy Schoenberger<br />
HJC GENERAL FUND<br />
Fred & Roslyn Belkin<br />
Zita Schneck<br />
In memory of David Schneck<br />
Harvey & Marion Yurow<br />
In memory of Aaron Kaplan<br />
Harvey & Marion Yurow<br />
In memory of Anne Maxwell<br />
Harvey & Marion Yurow<br />
In memory of Esther Finkelstein<br />
ONEG<br />
Meredith Evans<br />
Paula Mathai<br />
Michael Gordon<br />
Mi Sheberakh * We Pray for Healing<br />
Adam Hyman<br />
Jacob Corsman<br />
Paul Lever<br />
Amy Schoenberger<br />
Jason Sober<br />
Rabbi Fred Natkin<br />
Arlene Zweibach<br />
Jeni Wing<br />
Richard Collins<br />
Barbara Chancey<br />
Jimmy Chancey<br />
Robert Sachs<br />
Bea Kolchin<br />
Karen Green<br />
Rosie Lidy<br />
Bessie Speyer<br />
Kelcey Klass<br />
Sam Befarah<br />
Brandy Blazer<br />
Kimmie Rankin<br />
Shirley Oliner<br />
Carl Chancey<br />
Lee Tabackman<br />
Sidney Birnbaum<br />
Carl Tannenbaum<br />
Lori Vetstein<br />
Stewart Natkin<br />
Carol Buckman<br />
Margaret Hass<br />
Stu Needel<br />
David Richardson<br />
Marie Grove<br />
Teresa Cicotte<br />
Dvir Sabag<br />
Marshall Rosin<br />
Todd Young<br />
Fred Belkin<br />
Michael Schneck<br />
Tom Merriken<br />
Gerry Murphy<br />
Pat Wolkow<br />
Toni Bonney<br />
Harriet Colman<br />
Patrick Hauf<br />
18 | P a g e
=<br />
Recently Passed<br />
Stephen Hoffman<br />
Nephew to Barbara Litofsky, cousin to Natalie Litofsky and Lee & Kelly Litofsky, godfather to Heather Litofsky<br />
Ruth Glickman Budner<br />
Loretta Davis<br />
Bessie Kleiner<br />
Shirley Litwak<br />
Marilyn Richter<br />
Marvin Getz<br />
Leon Richter<br />
Joyce Irwin<br />
Dalton Newland<br />
Richard S. Salmansohn<br />
Evelyn Gast<br />
Philip N. Golbin<br />
Morris Pollack<br />
Harry Kale<br />
Evelyn Kempler<br />
Martin Newman<br />
Bertha Werde<br />
Anne Marie Smith<br />
Estelle Eisman<br />
Morris Gilden<br />
Stella Sazinsky<br />
Betty Chayt<br />
Morris Silver<br />
Bernice Better-Falk<br />
Susan Fine-Langsam<br />
Fredric Hoffman<br />
Jeffrey G. Myers<br />
Gladys Hecht<br />
<strong>November</strong> <strong>2019</strong> - Yahrzeits Observed<br />
Nov. 01<br />
Nov. 02<br />
Nov. 02<br />
Nov. 03<br />
Nov. 03<br />
Nov. 04<br />
Nov. 04<br />
Nov. 06<br />
Nov. 06<br />
Nov. 06<br />
Nov. 07<br />
Nov. 07<br />
Nov. 07<br />
Nov. 09<br />
Nov. 09<br />
Nov. 10<br />
Nov. 10<br />
Nov. 11<br />
Nov. 12<br />
Nov. 12<br />
Nov. 12<br />
Nov. 13<br />
Nov. 13<br />
Nov. 14<br />
Nov. 14<br />
Nov. 14<br />
Nov. 14<br />
Nov. 15<br />
Doris Jolsen Rosenfeld<br />
Bess Kaplan<br />
Ada Nathanson<br />
Nathan Goldstein<br />
Cathy Ann Glickstein<br />
Pearl Spring<br />
Irwin M. Wolkow<br />
George Robinson<br />
Julius Snyderman<br />
Fred Mullis<br />
Jacob Sadowsky<br />
Zachary Davis<br />
Alexander Brisker<br />
Daniel Katzoff<br />
Charlotte Maupin<br />
Isaac Pancer<br />
Samuel Berger<br />
Lena Apple<br />
Irene Alk Getz<br />
Melvin Howard Sang<br />
Lisa Schkloven<br />
Larry Spring<br />
Bettie Jones<br />
Jerrold Bress<br />
Ralph Klein<br />
Julia Pillersdorf<br />
William Weintraub<br />
Nov. 15<br />
Nov. 16<br />
Nov. 16<br />
Nov. 17<br />
Nov. 18<br />
Nov. 18<br />
Nov. 18<br />
Nov. 19<br />
Nov. 19<br />
Nov. 20<br />
Nov. 20<br />
Nov. 21<br />
Nov. 22<br />
Nov. 23<br />
Nov. 23<br />
Nov. 23<br />
Nov. 24<br />
Nov. 25<br />
Nov. 25<br />
Nov. 25<br />
Nov. 25<br />
Nov. 25<br />
Nov. 26<br />
Nov. 27<br />
Nov. 29<br />
Nov. 29<br />
Nov. 30<br />
19 | P a g e
20 | P a g e
21 | P a g e
22 | P a g e
Temple Adas Shalom<br />
8 North Earlton Road, Extension<br />
Havre de Grace, MD 21078<br />
Name<br />
Address<br />
City, State Zip<br />
23 | P a g e