Declaration Of Income And Expenses Page 4

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Notary Clause
_______________________________, Petitioner, is personally known to me or presented satisfactory
proof of identity to me. After being sworn and while under oath, Petitioner stated that he or she was
acting voluntarily, had read and understood the preceding document, and that the contents were true.
Petitioner then signed the document in my presence.
Signed on__________________________, 20_____.
X____________________________________
Notary Public/ Court Clerk
(Notary Seal)
4
May 6, 2006

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