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<br />MAR-26-Cl MON 1: 57 PM Cry OF FOREST LAKE <br /> <br />FAX Iro, 651 454 4852 <br /> <br />P. 5 <br /> <br />I HEREBY CERTIFY THAT I HAVE READ THE FOROOING QI..'ESTIONS AND !HAT THE <br />ANSWERS TO SAID Qv'ESnONS ARB TRUE OF MY OWN KNOWLEOO8, 11'URTIlER <br />UNDERSTAND THAT AN lNVESTIGATION, FEE NOT TO EXCE:eD $50.00, MAYBE CHARGED <br />TO AN APPLICA-""T BY TIlE CITY, IF CONVICTED 01' ANY CRIME OTHER tHAN A TRAFFIC <br />Ol'F.BNSE, I WILL REl'Oll.T SUCH CONliICnON TO THE OrY OF .!'ORBST l.AKE <br />IMMEDIATELY, <br /> <br />SIONAThllE OF APPLICANT AND DATE SIONED <br /> <br />I HEREBY AUTHORIZE TIlE FOREST LAKe POLlCl! DEPT. TO CHECK]\IN POLICE RECORD <br />AND DO HERESY RELEASE THE CITY OF .FORBSTLAI<E AND ALL lNDlVlDUALS <br />CONNECTED THEREWITH .FROM ALL LlAlllUIY FOR DAMAOE WHA rsoEVllR INCUlt\UlD <br />IN FURlI/ISH.L.'1C SUCH REPORT, <br /> <br />SIGNATh'RE OF APPLICANT <br /> <br />~~<A.L FEE ISSSO.OO PERC4.LENDAR YEAR <br />