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STATE OF MINNESOTA ) <br />ss. <br />COUNTY OF ) <br />I, _ uvc•�� �vs hereby depose and say that <br />all of thove statements and the statements contained in <br />the papers submitted herewith are true. <br />i <br />(Mailing Address - Str.,et)w <br />J , / <br />(c (State) -(Zip Code) <br />Subscribed and sw rn to before me this <br />day of 191, <br />i <br />L - - - -- -- <br />hlotaryc ubl is <br />My Commission Exilires: <br />- MANJCRIf L. VICKERY <br />iIOTARr PUBLIC - WWSOTA <br />MENHf P!tt'70 0.TY <br />■ 1Y: J' NYVW ■ <br />