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ll
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it
h n
a
m
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d
h
a
v
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ng kno
w
n h
im/
h
er
f
o
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y
ear
s;
t
h
a
t
(
s
)
h
e
is
o
f
good
re
pu
t
a
ti
on
i
n
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h
e
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it
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w
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(
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,
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h
a
t
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b
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h
im/
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t
o b
e
o
f
good
m
o
ra
l
c
h
arac
t
er
.
(
Si
gn
a
t
u
re)
(Da
t
e)
S
U
BSCR
I
B
ED
a
nd
s
w
o
r
n
t
o b
ef
o
re
m
e
t
h
is
d
a
y o
f
N
o
t
ar
y
P
ub
li
c
M
y
C
o
mmissi
on
e
xp
i
re
s:
(
S
E
A
L
)
NSBC 1:14 Rev. 10/2017
