Form 133.29 - Intrastate Exemption Notice Page 4
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133.29
with such application; and that to the best of his or her knowledge, information and belief the
statements made in such application are true and any documents submitted therewith are true
copies of the originals thereof.
(Signature)
(Printed name)
Subscribed and sworn to before me the ______ day of __________________________, 20____.
Notary Public in and for the County of
State of
(NOTARY SEAL)
My commission expires
08-16-2010
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