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STATE OF NORTH DAKOTA <br />as. <br />County of c_gS <br />1 fi`l••. 6)---rt-_ being first duly sworn, deposes and says <br />that is the.... .'.L'It lei/.2..S applicant who is described in and who executed the foregoing <br />and above application,that he has read each question and statement therein contained and knows the contents thereof, <br />and that he has made the answers set forth in said application, and that each one of said answers is true of his own <br />knowledge. <br />Subscribed and sworn to before me on this da of / " 1 G G "1 <br />20 .aw <br />r <br />Notary Public for ..---_- a5 5 <br />SEAL) County, North Dakota. <br />My commission expires 6*6 be` l 3l 0 a.--1 <br />@IAN PAM <br />11I4flakMs <br />Counallso • New 13, ', <br />ii <br />CLO II v <br />g 0CICl..) <br />IN <br />0. v NI0 <br />c <br />O = 4 a II <br />F) <br />v.i o V v <br />C ..o <br />cOuC °c° v Oi..+ <br />RS O a c ;..a I <br />c <br />i..+Qvo7 -o 0 .461 <br />C Q <br />Q, V v ' V <br />8 a o <br />z E A