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h ' <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 /> LJ owner ' s legal agent having Power of Attorney for this action (a <br /> notarized Power of Attorney document must accompany the <br /> application ) , <br /> 4RGERO <br /> f re ing is true and correct . <br /> 4187Date(ate ) <br /> (Signature ) (Date ) <br /> (Signature ) (Date ) <br /> Major Subdivision - 9 - ( 7/84 ) <br />