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Affidavit of <br />(Name of individual having personal knowledge of dry up) <br />State of Colorado ) <br />SS. <br />County of Otero ) <br />being sworn, state as follows: <br />Name <br />1. I am (describe the position that you are in or the <br />circumstance, which allows you to have a personal knowledge of the dry up of the parcel of <br />land described in paragraph 3 below). <br />2. I reside at <br />Address (Street/P.0., City, State ZIP) <br />3. The parcels of land shown on the attached map in the dried up acreage section of <br />the Arkansas River Replacement Plan Application for CWPDA was irrigated by water from the <br />Holbrook Canal prior to the dry up of the land for augmentation credit. <br />4. Based on my personal knowledge, the parcels of land shown on the attached map <br />and described in the dried up acreage section of the Arkansas River Replacement Plan <br />Application for CWPDA was not irrigated from the Holbrook Canal or from any other water <br />source in 2003. <br />Further, the affiant sayeth not. <br />Subscribed and sworn to before me on <br />My commission expires <br />Name <br />Address <br />of Affiant <br />Name <br />Address <br />Signature <br />Date <br />NOTARY PUBLIC <br />Signature <br />