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<br />SIGNATURE OF AFFIANT <br /> <br />(printed or Typed Legal Name of Affiant) <br /> <br />State of Florida of County of Miami-Dade <br />Sworn to and subscribed before me this <br />2009, <br /> <br />day of <br /> <br />by <br /> <br />Notary Seal: <br /> <br />Notary's Name Printed, Stamped or Typed <br /> <br />Personally Known: <br /> <br />or Produced Identification <br /> <br />Identification Produced <br /> <br />14 <br />