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114"r reed the Ajylk allun mkl lhr Prlllkl end Agtrrttlrot fol (W Special f vent ind l affirm rm the truth of <br />lhr kohu meuun lkovklyd hV mr to the hr+l of my klkkvirdiiie. I uekkrtitatkl alkl agree to the atiow rules <br />mul i vgi,Wllo o. mkl any +pplk ehlr ,6dr AW federal law+. 1 Also undentAlkl ttk l Irks Appi"tlon may be <br />'kowd W%rd on any false a lin ongdrte kofomwlknt <br />Date: J ' f c;Lo <br />4el, It <br />Printed Ntlttle: WIt{0 f ( q }/CO <br />SPECIAL EVENTS COMMITTEE APPROVAL <br />0 <br />