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WARNING: It is a crime to knowingly make false statements to a federal agency. <br />Penalties upon conviction can include a fine and imprisonment. For details, see Title 18 <br />U.S.C., Sections 1001 and 1010. <br />fv2MI. eAgntR vised for Green Initiative (October 2011) <br />C -2 <br />Owner <br />Dated: <br />201302388 <br />FRENCH VLLAGE <br />