ar practice. I declare under penalty of perjury that the foregoing is true and correct. Executed on O21,5- 40.20. (date) (signa ure o 1 ec arant VACQ1 talizia5e (name of business) 7747 Ik??e,.$ 110/7 &Ai (business address) — Definitions of terms used above: 4541em/ At D 7/03 As defined in Fed