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<br />I <br />I <br /> <br />State of Colorado <br />County of <br /> <br />55. <br /> <br />I <br />I <br />I <br /> <br />. being first duly sworn <br /> <br /> <br />upon oath. deposes and says that he has read the foregoing ap.plicatjon. <br /> <br /> <br />knows the contents thereof and that the same is true. <br /> <br />I <br /> <br />Subscribed and sworn to before me this <br /> <br />day of <br /> <br />.19_. <br /> <br />I <br /> <br />Notary Public <br /> <br />I <br />I <br /> <br />Name and Address <br />of Applicant: <br /> <br />Name. Address and Telephone Number <br />of Attorney for Applicant:. <br /> <br />I <br /> <br />I <br /> <br />I <br />I <br /> <br />I <br /> <br />I <br /> <br />I <br /> <br />I <br /> <br />I <br />I <br />