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2� 1 ���438 <br /> H�D SI��TATURE PA�E T� HEALTH�ARE RE�ULAT�RY A�`rREE�VIENT— <br /> �P�RAT�R1 <br /> U.S. DEPARTMENT UF H�USIN� <br /> AI�D iTRBAN DEVEL�PMEI�T <br /> Secretary of Housing and i�rban Developmen#, <br /> acting by and through the Federal Housing <br /> �omm�ssioner <br /> i]v. i <br /> .I ' �' <br /> R�ger A. Lew1s <br /> Auth�rized Agent <br /> �ffice �f Residential Care Facilities <br /> ACKN�WLEDGEMENT <br /> STATE �F WASHIN�T�N � <br /> � S5: <br /> ��UNTY �F KIN� } <br /> I �ertify that I �n�w or have s ti factory evidence that Ro�er A. Lewis is the person who <br /> appeared befare me, (]Il t�115 day of Se�tember, ��1�, and said p�rson acknowledged that <br /> he s�gned this instrument, on oath stated that he �was authorized ta execute the in�trument and <br /> acknoWledged it as the Authorized Agent of the Secretary of LJ.S. I]epartment of Housing and <br /> Urban Devel��ment, acting b� and through the Federal Hausing �ommiss�aner, I�irect�r in the <br /> �ffice of Residential Healthcar� Facilities, U.S. Department�f Housing and Urban <br /> D�velopment, and that he, being authorized t� do so by virtue �f such office, executed the <br /> foregaing instrument�n behaif of the Federal Housing �omrnission�r, acting for the Secretary of <br /> th�U.S. I]epartment of Housing and Urba.n Development, to be the fr�e and v�luntary act of <br /> such party for the uses and purposes menti�ned in the instrum�nt. <br /> �TITITNES S my hand and offic�al seal. <br /> � <br /> �SE Not ub ic � <br /> Not$ry p�xbuc = <br /> State of�Vash�n �n ' - � <br /> � Pr�nt Name � <br /> MARSHA A GALL��N <br /> � <br /> 11�Y C[]MNi�SS��N EXPIRES <br /> AU�usT 22,���� Re sid�ng at <br /> �;+i� r.�r.�_r_�t�_Il_L <br /> . . � <br /> My commission explres: <br /> Previous versions obsolete Page 'i 7 form HUD-9z4S6A-�RCF �Rev. �612��4} <br /> Repfaces HU D-924�6-N H L <br />