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-5- <br /> ►� 4. 1 understand that statements in the application are being made under penalty <br /> of perjury and that false statements made herein are punishable as a Class 1 <br /> misdemeanor pursuant to Section 18-8-503, C.R.S. <br /> Signed and dated this 0 day of T c <br /> Applic /Operat r 1f Corporation Attest'-(Seal) <br /> By. By: <br /> Title: _� orp rate Secre ary or Equivalent <br /> Town/City/County Clerk <br /> State of <br /> ss. <br /> County of Qv� ) <br /> The foregoing instrument <br /> nstruument was acknowledged before me this day of <br /> by /'�t/ �1 b/�iNE; a s _ Y /�? of /�CSTF��( <br /> itary Public � <br /> My Commission Expires: <br /> i - <br /> ' 2823F (02/05193) <br />