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SIGNATURE <br /> 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 /> uOwner ' s legal agent having Power of Attorney for this action (a <br /> notarized Power of Attorney document must accompany the <br /> application ) , <br /> and tha the fre ing is true and correct . / ^ <br /> VGRG RO (Date ) <br /> / 0-/60-S(p <br /> AMAGNA (Date ) <br /> (Signature ) (Date ) <br /> (Signature ) (Date ) <br /> Major Subdivision - 9 - ( 7/84 ) <br />