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<br /> <br />AFFIDAVIT <br />Applicant, or duly authorized representative, being first duly sworn, <br />states to the best of applicant's knowledge and belief that the infor- <br />mation furnished above is correct and complete. <br />BY <br />pelican <br />State of ~ p~pv ai~d r~ <br />County of ~te1.,o'c~~, <br />Subscribed and sworn to before my by 1.AwRGUe~ C9'• W1~~~.e. <br />this the \\ ~~ day of ~~ ,~" 19 $a. <br />My commission expires \D-~~1=~ ^•~-." <br />__ ~ -- <br />. ~- '. <br />.:. ; •. - <br />~~~~- ~-- <br />otary T~u6Tic ~~o-a "~~•~ <br />P~UROSL' C~ a~ayo <br />„~ ., <br />