_____________________________
________________________________
Supplier
Manufacturing
Alliance Associates, Inc.
_____________________________
_________________________________
Signature
Signature
_____________________________
________________________________
Print Name
Print Name
_____________________________
________________________________
Date
Date
AFFIDAVIT (Notarization
required.)
NOTARY
State of
_______________________County
of _________________ on the ____________ day of ___________ in the year
______
before me, the undersigned, personally appeared
_______________________,
personally known to me on the basis of satisfactory evidence to be the
individual whose name is subscribed to this application and
acknowledged to me
that he/she executed the application and swore that the statements made
by
him/her in the application and all supporting materials are true,
complete, and
correct.
Notary Public
signature_____________________________________
Notary ID
number_________________________
Expiration
date__________/_______/______________
Month
Day
Year
Notary
Stamp
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