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 · Affiant day of [month] [year] at [place of SUBSCRIBED AND SWORN to before me this ... If a corporation or joint venture: None of the officers, directors, and controlling stockholders

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Page 1:  · Affiant day of [month] [year] at [place of SUBSCRIBED AND SWORN to before me this ... If a corporation or joint venture: None of the officers, directors, and controlling stockholders
Page 2:  · Affiant day of [month] [year] at [place of SUBSCRIBED AND SWORN to before me this ... If a corporation or joint venture: None of the officers, directors, and controlling stockholders
Page 3:  · Affiant day of [month] [year] at [place of SUBSCRIBED AND SWORN to before me this ... If a corporation or joint venture: None of the officers, directors, and controlling stockholders
Page 4:  · Affiant day of [month] [year] at [place of SUBSCRIBED AND SWORN to before me this ... If a corporation or joint venture: None of the officers, directors, and controlling stockholders
Page 5:  · Affiant day of [month] [year] at [place of SUBSCRIBED AND SWORN to before me this ... If a corporation or joint venture: None of the officers, directors, and controlling stockholders
Page 6:  · Affiant day of [month] [year] at [place of SUBSCRIBED AND SWORN to before me this ... If a corporation or joint venture: None of the officers, directors, and controlling stockholders
Page 7:  · Affiant day of [month] [year] at [place of SUBSCRIBED AND SWORN to before me this ... If a corporation or joint venture: None of the officers, directors, and controlling stockholders
Page 8:  · Affiant day of [month] [year] at [place of SUBSCRIBED AND SWORN to before me this ... If a corporation or joint venture: None of the officers, directors, and controlling stockholders

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