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CERTIFICATION OF APPLICANT <br /> 1 certify rhai the information submitted with this application is rrue and correct 1 also certify that this <br /> document has not been altered or changed in any manner from the form odopted by the eoord of earber and <br /> ,� Cosmetologist Examiners. <br /> � �` <br /> � �/ <br /> Signatu e of Owner#1 Date <br /> Subscribed a �rn to bef re me <br /> This day of 20 � <br /> �. � <br /> � Notary Seal <br /> � RHEA S SMY <br /> Signature of Not N07qqypuBAl�SKi <br /> 'a-,,,�• M MINNESOTq <br /> Y Commla�bn cxp�res�an.31.�1P <br /> My Commission Expires`���'� <br /> Signature of Owner#2 Date <br /> Subscribed and Sworn to before me <br /> This day of , 20 <br /> Notary Seal <br /> Signature of Notary <br /> My Commission Expires <br /> Signature of Owner#3 Date <br /> Subscribed and Sworn to before me <br /> This day of , 20 <br /> Notary Seal <br /> Signature of Notary <br /> My Commission Expires <br /> 10 <br />