Information Request Form

Section:	Main.A1. CORP. INDEX. Hn-Hz.Huber J.M. Corp./P C2.2004. 02.02.2004. (CP Kelco)
Code:	70298
Product:	USA. H
Company or Organization:
Contact's name *:
Position:
E-mail:
Mailing address:
Phone number:
Fax number:
Fields of interest:	SHAREHOLDER'S COMPOSITION
* If you are not linked to any company or organization complete at least this field