FORM FOR VERIFICATION

CORPORATE VERIFICATION State of _ ) ) SS. County of _ ) ___________________________, being first duly sworn, says that ..he is the __________________________________________ of ________________________________________ above-named applicant, and executes this instrument for and in its behalf, by authority of its board of directors; that ..he has read the foregoing application, including all exhibits submitted therewith, and states that the contents thereof are true to the best of h.. knowledge and belief. _ Subscribed and sworn to before me this _ day of _ , _ . _ Notary Public, _ County _ My Commission expires: _ INDIVIDUAL VERIFICATION State of _ ) ) SS. County of _ ) _________________________________, being first duly sworn, says that ..he is ________________________________________________ applicant; that ..he has read the foregoing application, including all exhibits submitted therewith, and states that the contents thereof are true to the best of h.. knowledge and belief. _ Subscribed and sworn to before me this _ day of _ , _ . _ Notary Public, _ County _ My Commission expires: _