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I certify under penalty of perjury that I am (check one): <br />Legal Owner(s) (All owners must sign as their names appear on the <br />deed.), <br />corporate Officer(s) empowered to sign for the corporation, <br />LI Owner's legal agent having Power of Attorney for this action (a <br />notarized Power of Attorney document must accompany the <br />application), <br />and that the foregoing is true and correct. <br />(Signature) <br />(Signature) <br />(Signature <br />gnature) <br />Major Subdivision <br />- 9 - <br />(Date) <br />(Date) <br />(Date) <br />(Date) <br />(7/84) <br />