Annual Gross Revenue Return Form And Statement Of Assessment Due - Office Of Public Carrier Regulations Of Delaware Department Of Transportation Page 4

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ANNUAL REPORT 2006
I (we) the undersigned, trading as ______________________________________________
on my (our) oath do say that the following return has been prepared under my (our) direction from
the original books, papers and records of this carrier and that I (we) have carefully examined same
and declare it to be a complete and correct statement of the business and affairs of said carrier to the
best of my (our) knowledge, information and belief.
__________________________________
SIGNATURE
__________________________________
TITLE
Subscribed and sworn to before me this __________________ day of
__________________, 20______.
_____________________________
NOTARY PUBLIC
(SEAL)

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