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* ' COUNTY FORM 170 <br />11 <br />DECLARATION <br />This form is to be signed by the preparer of a document and recorded with each document <br />in accordance with IC 36-2-7.5-5(a). <br />1, the undersigned preparer of the attached document, in accordance with IC 36-2-7.5, do <br />hereby affirm under the penalties of perjury: <br />true. <br />I HAVE REVIEWED THE ATTACHED DOCUMENT FOR THE PURPOSE <br />OF IDENTIFYING AND, TO THE EXTENT PERMITTED BY LAW, <br />REDACTING ALL SOCIAL SECURITY NUMBERS. <br />2. 1 HAVE REDACTED, TO THE EXTENT PERMITTED BY LAW, EACH <br />SOCIAL SECURITY NUMBER IN THE ATTACHED DOCUMENT. <br />1, the undersigned, affirm under penalties of perjury, that the foregoing declarations are <br />Signature of Declarant <br />Printed Name of Declarant <br />F.-DATA'SHAREkLegallWpdatalSEPkEconomicDevelopmentkBillie'slState CafekState Cafe Lease (version 5)-doc <br />