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~ ~ <br />aTAT3 OP COLORADO, -) <br />cattnt, ar j1 °' - <br />I hereby orrtitp that I have xrved the avithia 3ubp«aa Dam Tecum is the County d.____.~ <br />1f1___..._., b~ • <br />and paid to the peaaa w xrred ;i __._witaeaa fee and i.. ~+1esge. <br />Sasstn'. <br />Dcrvrs. <br />~TOS3 al CCLORiDO, <br />County at <br />_~~ <br />Lhe affiant, being sworn, aapa: <br />that af5snt is ours tSe aga of eighte•_a yenta sad is not a party to this action; and that a°.Sant ksi xrred the <br />teithia Supoe:a Dt:eesTetum in the County oC ,Colorado, on the - <br />day n! y I9-, by <br />sad said to tya peraoa so xsved ; i witaw fee sad J__________~ilm~, <br />Subaerbed sad swam to beforr ms thia_._~._ ..day of ______..~ 19._,~ <br />~iy co~~°~+on upirn ._ ... ..r <br />(Szat or :vo~c~az) <br />:tarsaz Prar.:c <br />'~4:s a1aLK of IVr:R <br />YSPitaexn an eaG:sd :a a !•s !or e•cS day'a armdaaee u~ Cpurt •eecefias 'o et.- of u Couat~, and cu2esjs k t3• ea4 <br />o! IS cents ,far a:i2• oas ~s~ <br />~n ~Ca+l `.a itdend tSe !en for oa• d•I+e •Ceadsom -ad :a,?eags ~6ea reed, es«pt wt~ea th• 3ubpoear Doees 2'eeua iu <br />is+uod oa. yet•i! o! ~e »:e at Calotada or at oc'~ca or a;tacp theted. <br />,. <br /> <br />Fees - - - - - <br />~f~es3e - .. - ._ <br />Fee and JSSesge of <br />Witness - - -- <br />Total - - - - -• i <br />~.~....~.ao.~... <br />