AFFIDAVIT OF ONE AND THE SAME

STATE OF
COUNTY
OF

I, , residing at ,

in the county of in the state of

and being duly sworn, do hereby depose and attest that:

1. I am known by the following names:

2. I have perused the document(s) carefully.

3. The name(s) in the

aforementioned document apply to me.

Affiant Date

Subscribed and sworn to before me

this day of 20

(Notary Public),

County.
My commission expires 20

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