| United States. Congress. House. Committee on Interior and Insular Affairs - 1966 - 622 lapas
...Applicant's certification : I, , on this date, , do hereby (print your full name) (month day year) declare that to the best of my knowledge the information I have entered on this application form is true and correct ; and that further I pledge it is my intent, to... | |
| United States. General Accounting Office - 1993 - 36 lapas
...possible in the envelope found in this booklet. KEEP A COPY FOR YOUR RECORDS. I have read this return. Under penalties of perjury, I declare that to the best of my knowledge and belief, the return is true, correct, and complete. Your signature Date For Paperwork Reduction... | |
| DIANE Publishing Company - 1996 - 54 lapas
...service shown in 33. (Give serial or registration number, address, etc.) Business That Received Cash 42 Under penalties of perjury, I declare that to the...knowledge the information I have furnished above is true,'«orrect, and complete. (Authorized signature of business that received cash) (Title) (Date signed)... | |
| Patricia L. Donahue - 1999 - 300 lapas
...or money order for the full amount, payable to "Internal Revenue Service." I have read this return. Under penalties of perjury, I declare that to the best of my knowledge and belief, the return is true, correct, and complete. Your signature Date X ( OMB No. 1545-0675 Please... | |
| Joyce Bea Sterling - 2001 - 270 lapas
...(Give serial or registration number, address, docket number, etc.) ^ Business That Received Cash 42 Under penalties of perjury, I declare that to the best of my knowledge the informatio.i I have furnished above is true, correct, and complete. Title of authorized official For... | |
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