Professional Documents
Culture Documents
ti
fi
cat
eofResi
dency
Dat
e:_
___
___
___
___
___
___
I
,___
_____
_____
_____
_____
_____
_____
_____
__,oflegalage,withpost
aladdressand
r
esidentaddressat____
_____
_____
_____
_____
_____
_____
__ _
_______
__ _
____
___
______
____
__
_________
_____
_____
_____
_____
_____
_____
_____
_____
, do her eby cer t
if
ies t hat
__
_________
_____
_____
_____
_____
_____
_____
___,is presentlyr esi
ding at the address
mentionedabove.
Donef
orwhat
everl
egal
pur
posei
tmayser
ve.
Si
ncer
elyy
our
s,
Si
gnat
ureov
erpr
int
edname
conf
orme:
_
___
___
___
___
___
___
___
___
___
___
___
Pur
chaser