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SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> x� Legal Property Owner (owner includes partner, trustee, trustor , or <br /> corporate officer . ) <br /> Ld Owner 's legal agent (attach proof of the owner 's consent to file <br /> the application ) , <br /> and that the foregoing is true and correct. <br /> �l <br /> { January 30, 1967 <br /> ( gnature ) (Date ) <br /> -8- ( 9/85) <br />