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Recorded at (Place) .. ~<??h-ll.l. .....l!!·d~~?-... .. On (Date) .... >.~. . t1., .!{ ..... At (Time) .. ./.~:.:?) fi::.w· Name, Rank, and Number of recording officcr ............f!.•j.ifvfJ#; .......;.r/.4.(~/~r{ ....

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This statement, consisting of ( ) pages each signed by me, is true to the best of my knowledge and belief, and that I make it knowing that if it is tendered in evidence, I shall be liable to prosecution if I have willfully stated in it anything which ~w to be false or do not believe to be true /1 _/ / , / ' 1

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This statement, consisting of ( ) pages each signed by me, is true to the best of my knowledge and belief, and that I make it knowing that if it is tendered in evidence, I shall be liable to prosecution if I have willfully stated in it anything which I k:;:le't}' to be ~ or do ./-;:_ not believe to be true ,_../"/ s·1gne d·. ~/"~,. ·1 / fl yc.. .~ -:_,::-.~·.-/:r::,/-:'/ ..., [~ i Witness'jif-aiCn y),...--: _(/

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This statement, consisting of ( ) pages each signed by me, is true to the best of my knowledge and belief, and that I make it knowing that if it is tendered in evidence, I shall be liable to prosecution if I have willfully stated in it anything which I knew to be false or do not believe to be true ,...-, h iP . d . /~; 0'7, /} ~ -- ~· S 1gne : .14--' /:&• .../t>', ~-1 / Y.ti,._<; 0/fl"'L I Witness ((-ii;;;an}lf:~ .7't?"

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This statement, consisting of ( ) pages each signed by me, is true to the best of my

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