Information Request Form

Section:	Main.A1. CORP. INDEX. F-Fm.Fermic S.A. de C.V./P C2.2004. 02.23.2004. Diversa
Code:	73774
Product:	Mexico. F
Company or Organization:
Contact's name *:
Position:
E-mail:
Mailing address:
Phone number:
Fax number:
Fields of interest:	ALLIANCE
* If you are not linked to any company or organization complete at least this field