Business Financial Statement Page 6
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6I hereby certify under penalty of perjury that the information contained in this confidential financial report,
including supplemental schedules, has been carefully examined by me and is correct and complete and further
acknowledge that there are no misrepresentation or omissions of material facts.
Dated and signed this _____ day of ___________________, 20____.
________________________________________
(Signature)
________________________________________
(Typed or Printed Name)
________________________________________
(Title)
CORP – P04 [8/12]
Texas Department of Banking
Page 6
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