Minnesota Administrative Rules

2860.9920 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: _

Statutory Authority:

MS s 80C.18

History:

17 SR 1279; L 1998 c 254 art 1 s 107

Published Electronically:

September 14, 2007