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Proc-Type: 2001,MIC-CLEAR
Originator-Name: webmaster@www.sec.gov
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<SEC-DOCUMENT>0001181431-02-002797.txt : 20021210
<SEC-HEADER>0001181431-02-002797.hdr.sgml : 20021210
<ACCEPTANCE-DATETIME>20021210155356
ACCESSION NUMBER:		0001181431-02-002797
CONFORMED SUBMISSION TYPE:	4
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20021206
FILED AS OF DATE:		20021210

SUBJECT COMPANY:	

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			PIZZA INN INC /MO/
		CENTRAL INDEX KEY:			0000718332
		STANDARD INDUSTRIAL CLASSIFICATION:	WHOLESALE-GROCERIES & RELATED PRODUCTS [5140]
		IRS NUMBER:				470654575
		STATE OF INCORPORATION:			MO
		FISCAL YEAR END:			0626

	FILING VALUES:
		FORM TYPE:		4
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	000-12919
		FILM NUMBER:		02853638

	BUSINESS ADDRESS:	
		STREET 1:		5050 QUORUM DR STE 500
		CITY:			DALLAS
		STATE:			TX
		ZIP:			75240
		BUSINESS PHONE:		2147019955

	MAIL ADDRESS:	
		STREET 1:		5050 QUORUM DR STE 500
		STREET 2:		5050 QUORUM DR STE 500
		CITY:			DALLAS
		STATE:			TX
		ZIP:			75240

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	CONCEPT DEVELOPMENT INC
		DATE OF NAME CHANGE:	19870212

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	PANTERAS CORP
		DATE OF NAME CHANGE:	19901126

REPORTING-OWNER:	

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			WELLS FARGO & CO/MN
		CENTRAL INDEX KEY:			0000072971
		STANDARD INDUSTRIAL CLASSIFICATION:	NATIONAL COMMERCIAL BANKS [6021]
		RELATIONSHIP:				OWNER
		IRS NUMBER:				410449260
		STATE OF INCORPORATION:			DE
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		4

	BUSINESS ADDRESS:	
		STREET 1:		420 MONTGOMERY ST
		STREET 2:		SIXTH AND MARQUETTE
		CITY:			SAN FRANCISCO
		STATE:			CA
		ZIP:			94163
		BUSINESS PHONE:		6126671234

	MAIL ADDRESS:	
		STREET 1:		WELLS FARAGO CENTER
		STREET 2:		SIXTH & MARQUETTE
		CITY:			MINNEAPOLIS
		STATE:			MN
		ZIP:			55479

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	NORTHWEST BANCORPORATION
		DATE OF NAME CHANGE:	19830516

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	NORWEST CORP
		DATE OF NAME CHANGE:	19920703
</SEC-HEADER>
<DOCUMENT>
<TYPE>4
<SEQUENCE>1
<FILENAME>rrd1663.htm
<DESCRIPTION>FORM 4
<TEXT>

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SEC Form 4
<TABLE width=100% border=1 cellspacing=0 cellpadding=4>
<TR>
<TD width=254 valign=top>
    <div align=center><font size=4 face=arial,helvetica><b>FORM 4</b></font></div>
    <br><div><font size=1 face=arial,helvetica><b>[X] Check this box if no longer<br>subject to Section 16.  Form 4 or Form<br>5 obligations may continue.<br>See Instruction 1(b).</b></font></div>
</TD>
<TD width=764 valign=middle align=center>
    <font face=arial,helvetica><b>UNITED STATES SECURITIES AND EXCHANGE COMMISSION</b></font><br>
    <font size=1 face=arial,helvetica><b>Washington, D.C.&nbsp;&nbsp;20549</b></font><br><br>
    <font size=2 face=arial,helvetica><b>STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP</b></font><br><br>
    <font size=1 face=arial,helvetica>Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility</font><br>
    <font size=1 face=arial,helvetica>Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940</font><br>
</TD>
<TD width=254 valign=top>
    <div align=center><font size=1 face=arial,helvetica>OMB APPROVAL</font></div>
    <br><div align=center><hr width=98%></div><br>
    <div><font size=1 face=arial,helvetica>OMB Number: 3235-0287</font></div>
    <div><font size=1 face=arial,helvetica>Expires: January 31, 2005<br>Estimated average burden<br>hours per response. . . . . 0.5</font></div>
</TD>
</TR>

</TABLE>

<TABLE width=100% border=1 cellspacing=0 cellpadding=4>

<TR>
<TD width=446 valign=top>
    <div><font size=1 face=arial,helvetica>1. Name and Address of Reporting Person<sup>*</sup></font></div>
    <div><font size=1 face=arial,helvetica><b>Wells Fargo & Company</b></font></div>
    <div align=center><hr width=98%></div>
    <div align=center><font size=1 face=arial,helvetica>(Last) &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;(First) &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;(Middle)</font></div>
    <div><font size=1 face=arial,helvetica><b>420 Montgomery Street</b></font></div>
    <div><font size=1 face=arial,helvetica><b></b></font></div>
    <div align=center><hr width=98%></div>
    <div align=center><font size=1 face=arial,helvetica>(Street)</font></div>
    <div><font size=1 face=arial,helvetica><b>San Francisco,&nbsp; &nbsp; CA&nbsp; &nbsp;94104</b></font></div>
    <div align=center><hr width=98%></div>
    <div align=center><font size=1 face=arial,helvetica>(City) &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;(State) &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;(Zip)</font></div>
    <br>
</TD>
<TD width=254 valign=top>
    <div><font size=1 face=arial,helvetica>2. Issuer Name<BR> and Ticker or Trading Symbol</font></div><br>
    <div><font size=1 face=arial,helvetica><b>Pizza Inn, Inc.<BR>pzzi</b></font></div>
    <div align=center><hr width=98%></div>
    <div><font size=1 face=arial,helvetica>3. I.R.S. Identification<br>&nbsp;&nbsp;&nbsp;&nbsp;Number of Reporting<br>&nbsp;&nbsp;&nbsp;&nbsp;Person, if an entity<br>&nbsp;&nbsp;&nbsp;&nbsp;(voluntary)</font></div>
    <div><font size=1 face=arial,helvetica><b>41-0449260</b></font></div>
</TD>
<TD width=190 valign=top>
    <div><font size=1 face=arial,helvetica>4. Statement for<br>&nbsp;&nbsp;&nbsp;&nbsp;Month/Day/Year</font></div><br>
    <div><font size=1 face=arial,helvetica><b>12/06/2002</b></font></div>
    <br><div align=center><hr width=98%></div>
    <div><font size=1 face=arial,helvetica>5. If Amendment,<BR>&nbsp;&nbsp;&nbsp;&nbsp;Date of Original<br>&nbsp;&nbsp;&nbsp;&nbsp;(Month/Day/Year)</font></div><br>
    <div><font size=1 face=arial,helvetica><b></b></font></div>
</TD>
<TD width=382 valign=top>
    <div><font size=1 face=arial,helvetica>6. Relationship of Reporting Person(s) to Issuer</font></div>
    <div align=center><font size=1 face=arial,helvetica>(Check all applicable)</font></div><br>
    <div><font size=1 face=arial,helvetica><u>&nbsp;&nbsp;</u> Director &nbsp;
    <u>X</u> 10% Owner</font></div>
    <div><font size=1 face=arial,helvetica><u>&nbsp;&nbsp;</u> Officer (give title below) &nbsp; &nbsp;
    <u>&nbsp;&nbsp;</u> Other (specify below)</font></div>
    <br>
    <div><font size=1 face=arial,helvetica>Description &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
    <b><u></u></b></font></div>
    <div align=center><hr width=98%></div>
    <div><font size=1 face=arial,helvetica>7. Individual or Joint/Group<br> &nbsp; &nbsp; Filing (Check Applicable Line)</font></div>
    <br><div><font size=1 face=arial,helvetica><u>&nbsp;&nbsp;</u> &nbsp; Form filed by One Reporting Person</font></div>
    <div><font size=1 face=arial,helvetica><u>X</u> &nbsp; Form filed by More than One Reporting Person</font></div>
</TD>
</TR>
</TABLE>
<BR>
<TABLE width=100% border=1 cellspacing=0 cellpadding=4>
<TR>
<TD width=100% valign=top colspan=16>
    <div align=center><font size=1 face=arial,helvetica><b>Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned</b></font></div>
</TD>
</TR>

<TR>
<TD width=280 valign=top rowspan=2>
    <div><font size=1 face=arial,helvetica>1. Title of Security<br>&nbsp;&nbsp;&nbsp;&nbsp;(Instr. 3)</font></div><br>
</TD>

<TD width=64 valign=top rowspan=2>
    <div><font size=1 face=arial,helvetica>2.Transaction<BR>Date<br>(Month/Day/Year)</font></div>
</TD>
<TD width=64 valign=top rowspan=2>
    <div><font size=1 face=arial,helvetica>2A. Deemed Execution Date, if any<br>(Month/Day/Year)</font></div>
</TD>
<TD width=100 valign=top colspan=2>
    <font size=1 face=arial,helvetica>3. Transaction<br>&nbsp;&nbsp;&nbsp;&nbsp;Code<br>&nbsp;&nbsp;&nbsp;&nbsp;(Instr. 8)</font>

</TD>
<TD width=320 valign=top colspan=3>
    <font size=1 face=arial,helvetica>4. Securities Acquired (A) or Disposed Of (D)<br>&nbsp;&nbsp;&nbsp;&nbsp;(Instr. 3, 4, and 5)</font>

</TD>
<TD width=140 valign=top rowspan=2>
    <div><font size=1 face=arial,helvetica>5. Amount of<br>&nbsp;&nbsp;&nbsp;&nbsp;Securities<br>&nbsp;&nbsp;&nbsp;&nbsp;Beneficially<br>&nbsp;&nbsp;&nbsp;&nbsp;Owned Following<br>&nbsp;&nbsp;&nbsp;&nbsp;Reported Transaction(s)<br><br>&nbsp;&nbsp;&nbsp;&nbsp;(Instr. 3 and 4)</font></div>
</TD>
<TD width=114 valign=top rowspan=2>
    <div><font size=1 face=arial,helvetica>6. Owner-<br>&nbsp;&nbsp;&nbsp;&nbsp;ship<br>&nbsp;&nbsp;&nbsp;&nbsp;Form:<br>&nbsp;&nbsp;&nbsp;&nbsp;Direct (D)<br>&nbsp;&nbsp;&nbsp;&nbsp;or<br>&nbsp;&nbsp;&nbsp;&nbsp;Indirect (I)<br><br>&nbsp;&nbsp;&nbsp;&nbsp;(Instr. 4)</font></div>
</TD>
<TD width=190 valign=top rowspan=2>
    <div><font size=1 face=arial,helvetica>7. Nature of<br>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Indirect<br>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Beneficial<br>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Ownership<br><br>&nbsp;&nbsp;&nbsp;&nbsp;(Instr. 4)</font></div>
</TD>
</TR>
<TR>
<TD>
 <div align=center><font size=1 face=arial,helvetica>Code</font></div>
 </TD>
 <TD>
  <div align=center><font size=1 face=arial,helvetica>V</font></div>
  </TD>
  <TD>
  <div align=center><font size=1 face=arial,helvetica>Amount</font></div>
  </TD>
  <TD>
  <div align=center><font size=1 face=arial,helvetica>A/D</font></div>
  </TD>
  <TD>
  <div align=center><font size=1 face=arial,helvetica>Price</font></div>
  </TD>
  </TR>


	<TR>
		<TD width=280 align=left>
		    <div><font size=1 face=arial,helvetica><b>Common Stock, par value $0.01 per share</b></font></div>
		</TD>
		<TD width=64 align=center>
		    <div><font size=1 face=arial,helvetica><b>12/06/2002</b></font></div>
		</TD>
		<TD width=64 align=center>
		    <div><font size=1 face=arial,helvetica><b></b></font></div>
		</TD>
		<TD width=100>
			<div align=center><font size=1 face=arial,helvetica><b>J</b></font></div>
		</TD>
		<TD width=100>
			<div align=center><font size=1 face=arial,helvetica><b></b></font></div>
		</TD>

		<TD width=320>
			<div align=center><font size=1 face=arial,helvetica><b>2,905,000(1)(2)</b></font></div>
		</TD>
			<TD width=320>
			<div align=center><font size=1 face=arial,helvetica><b>D</b></font></div>
		</TD>
			<TD width=320>
			<div align=center><font size=1 face=arial,helvetica><b>$N/A</b></font></div>
		</TD>
		<TD width=140 align=center>
			<div align=center><font size=1 face=arial,helvetica><b></b></font></div>
		</TD>
		<TD width=114 align=center>
			<div align=center><font size=1 face=arial,helvetica><b>I</b></font></div>
		</TD>
		<TD width=190 align=left>
			<div><font size=1 face=arial,helvetica><b>By Pledgor under Pledge Agreement (1)</b></font></div>
	</TD>
	</TR>


</TABLE>

<TABLE width=100% border=1 cellspacing=0 cellpadding=4>
<TR>
<TD width=100% valign=top colspan=16>
    <div align=center><font size=1 face=arial,helvetica><b>Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned</b></font></div>
    <div align=center><font size=1 face=arial,helvetica><b>(e.g., puts, calls, warrants, options, convertible securities)</b></font></div>
</TD>
</TR>

<TR>
<TD width=102 valign=top rowspan=2>
    <div><font size=1 face=arial,helvetica>1. Title of Derivative Security<br>&nbsp;&nbsp;&nbsp;&nbsp;(Instr. 3)</font></div>
</TD>
<TD width=76 valign=top rowspan=2>
    <div><font size=1 face=arial,helvetica>2. Conver-<br>&nbsp;&nbsp;&nbsp;&nbsp;sion or<br>&nbsp;&nbsp;&nbsp;&nbsp;Exercise<br>&nbsp;&nbsp;&nbsp;&nbsp;Price of<br>&nbsp;&nbsp;&nbsp;&nbsp;Deri-<br>&nbsp;&nbsp;&nbsp;&nbsp;vative<br>&nbsp;&nbsp;&nbsp;&nbsp;Security</font></div>
</TD>
<TD width=76 valign=top rowspan=2>
    <div><font size=1 face=arial,helvetica>3. Transaction Date<br><br>(Month/<BR>Day/<BR>Year)</font></div>
</TD>
<TD width=76 valign=top rowspan=2>
    <div><font size=1 face=arial,helvetica>3A. Deemed Execution Date, if any
<br><br>(Month/<BR>Day/<BR>Year)</font></div>
</TD>
<TD width=78 valign=top colspan=2>
    <font size=1 face=arial,helvetica>4. Transaction Code</font><br>
    <font size=1 face=arial,helvetica>&nbsp;&nbsp;&nbsp;&nbsp;(Instr.8)</font>


</TD>
<TD width=160 valign=top colspan=2>
    <font size=1 face=arial,helvetica>5. Number of Derivative<br>&nbsp;&nbsp;&nbsp;&nbsp;Securities Acquired (A)<br>&nbsp;&nbsp;&nbsp;&nbsp;or Disposed Of (D)<br><br>&nbsp;&nbsp;&nbsp;&nbsp;(Instr. 3, 4 and 5)



</TD>
<TD width=162 valign=top colspan=2>
    <div><font size=1 face=arial,helvetica>6. Date Exercisable(DE) and<br>&nbsp;&nbsp;&nbsp;&nbsp;Expiration Date(ED)<br>&nbsp;&nbsp;&nbsp;&nbsp;(Month/Day/Year)</font></div>


</TD>
<TD width=186 valign=top colspan=2>
    <div><font size=1 face=arial,helvetica>7. Title and Amount of<br>&nbsp;&nbsp;&nbsp;&nbsp;Underlying Securities<br>&nbsp;&nbsp;&nbsp;&nbsp;(Instr. 3 and 4)</font></div>


</TD>
<TD width=76 valign=top rowspan=2>
    <div><font size=1 face=arial,helvetica>8. Price<br>&nbsp;&nbsp;&nbsp;&nbsp;of<br>&nbsp;&nbsp;&nbsp;&nbsp;Derivative<br>&nbsp;&nbsp;&nbsp;&nbsp;Security<br>&nbsp;&nbsp;&nbsp;&nbsp;(Instr.5)</font></div>
</TD>
<TD width=102 valign=top rowspan=2>
    <font size=1 face=arial,helvetica>9. Number of<br>&nbsp;&nbsp;&nbsp;&nbsp;Derivative<br>&nbsp;&nbsp;&nbsp;&nbsp;Securities<br>&nbsp;&nbsp;&nbsp;&nbsp;Beneficially<br>&nbsp;&nbsp;&nbsp;&nbsp;Owned<br>&nbsp;&nbsp;&nbsp;&nbsp;Following<br>&nbsp;&nbsp;&nbsp;&nbsp;Reported<br>&nbsp;&nbsp;&nbsp;&nbsp;Transaction(s)<br>&nbsp;&nbsp;&nbsp;&nbsp;(Instr.4)</font>
</TD>
<TD width=50 valign=top rowspan=2>
    <font size=1 face=arial,helvetica>10. Owner-<br>ship<br>Form of<br>Deriv-<br>ative<br>Securities:<BR>Direct (D)<br>or<BR>Indirect (I)<br><BR>(Instr.4)</font>
</TD>
<TD width=128 valign=top rowspan=2>
    <font size=1 face=arial,helvetica>11. Nature of<br>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Indirect<br>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Beneficial<br>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Ownership<br>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(Instr.4)</font>
</TD>
</TR>
<TR>
<TD valign=bottom>
<div align=center><font size=1 face=arial,helvetica>Code</font></div>
</TD>
<TD valign=bottom>
<div align=center><font size=1 face=arial,helvetica>V</font></div>
<TD valign=bottom>
<div align=center><font size=1 face=arial,helvetica>A</font></div>
</TD>
<TD valign=bottom>
<div align=center><font size=1 face=arial,helvetica>D</font>
<TD valign=bottom>
<div align=center><font size=1 face=arial,helvetica>DE</font></div>
</TD>
<TD valign=bottom>
<div align=center><font size=1 face=arial,helvetica>ED</font></div>
</TD>
<TD valign=bottom>
<div align=center><font size=1 face=arial,helvetica>Title</font></div>
</TD>
<TD valign=bottom>
<div align=center><font size=1 face=arial,helvetica>Amount or Number of Shares</font></div>
</TD>

</TR>





   <BR>

</TABLE>
<font size=1 face=arial,helvetica><B>Explanation of Responses:</B> </font><br>

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<TR>
    <TD width=100% align=right><font size=1 face=arial,helvetica><b>&nbsp;</b></font><br>
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<TD width=1272>

    <div><font size=2 face=arial,helvetica>(1)  Wells Fargo Bank Texas, National Association ("WFB Texas") is an indirectly wholly owned subsidiary of the Reporting Person and a joint filer to this Form 4.  WFB Texas acquired these shares when it gave notice to an insider of the Issuer of WFB Texas' intent to exercise voting rights and dispose of shares of the Issuer pledged by such insider to WFB Texas.  The obligation to WFB Texas secured by the pledge of the shares shown on Line 1 of Table I was discharged in full on December 6, 2002, and WFB Texas subsequently released its pledged interest in such shares. <p>(2)  Excludes 3,239 shares held in customer or fiduciary accounts in the ordinary course of business by Wells Fargo Bank Minnesota, National Association, an indirectly wholly owned subsidiary of the Reporting Person.<br></font></div>
</TD>
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<TABLE width=100% border=0>
<TR>
<TD width=40% valign=top>
    <font size=2 face=arial,helvetica><b>By: </b><br><U>/s/ Laurel A. Holschuh, Senior Vice President and Secretary</U>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<u>December 10, 2002</U>
<br>** Signature of Reporting Person &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Date &nbsp; &nbsp; &nbsp;</font><br><br><font size=1 face=arial,helvetica><b></b></font><br><br>
    <div align=right><font size=1 face=arial,helvetica><br>SEC 1474 (9-02)</font></div>
</TD>
</TR>
<TR>
<TD width=60% valign=top>
    <font size=1 face=arial,helvetica>Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.<BR><BR>
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).<BR>
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).<BR>
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
<BR>
Potential persons who are to respond to the collection of information contained in this form are not<BR>
required to respond unless the form displays a currently valid OMB Number.

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