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District 4 2015
Placing a true and correct copy of said document in
an envelope addressed to
at
in the City of
Zip Code
, State of
,
and depositing the envelope, with sufficient postage, in the United States
Mail at the Post Office located in the City of
in the State of
.
I declare under penalty of perjury that everything I have stated in this document is true and
correct. Minn. Stat. § 358.116.
Dated:
Signature
Name:
Address:
City/State/Zip:
E-mail address:
DIV409
State
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