FORM C DECLARATION TO BE MADE IN THE PRESENCE

DECLARATION BY THE NOMINATED ADVISER PURSUANT TO THE
DECLARATION OF ABANDONMENT STATE OF LOUISIANA PARISH
!doctype Html html Langengb head ! Mint System Declarations

(declaration Letter to be Submitted to Ura) to Chief
(LETTERHEAD OF COMPANY) OWN PRODUCTION DECLARATION TO THE GOVERNMENT
(TRANSLATION) NANNING DECLARATION ON CHINAASEAN HEALTH COOPERATION AND DEVELOPMENT

DECLARATION TO BE MADE IN THE PRESENCE OF A JUSTICE OF PEACE/COMMISSIONER OF OATHS

FORM C

DECLARATION TO BE MADE IN THE PRESENCE OF A JUSTICE OF PEACE/COMMISSIONER OF OATHS

I hereby declare under oath/confirm that the particulars furnished in the preceding application in respect of the agricultural remedy concerned or any label which is being used in connection therewith, do not deviate in any manner whatsoever from the congruent particulars which have already been registered or approved in relation to t hat agricultural remedy or label.

_______________________________________________________

INITIALS AND SURNAME

____________________________ _________________ ________________

SIGNATURE OF APPLICATION DATE TEL. NO.

I certify that the deponent has acknowledged that he/she knows and understands the contents of this declaration which was sworn to / affirmed before me and the deponent's signature was placed thereon in my presence.

_________________________________________________

COMMISSIONER OF OATHS

First names and surname ________________________________________________

(BLOCK LETTERS)

Designation (rank) _____________________________________________________

Business address: _____________________________________________________

(Street address must be stated)

Date: __________________________ Place: ________________________________

Declaration/ae

022011 SUPP (CRICCRC1) SUPERVISOR STANDARD AND DECLARATION FORM
022011 SUPP(CRI3) SUPERVISOR STANDARD AND DECLARATION FORM USE
1 IDENTIFICATION DE LA DECLARATION 11 CHANGEMENT

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