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STATEOFMINNESOTA � <br />)ss. <br />County of } <br />Being first duly svvorn, deposes and says that helshe is the <br />authorized representative of the applicant named herein, that helshe has read said application and knows the <br />contents thereof, and that the matters stated therein are true and correct. <br />Name Title <br />Subscribed and sworn to before me this <br />day of , 2b <br />Notary Public, County, Minn. <br />My commission expires <br />RECOMMENDATION OF COUNTY BOARD UPON APPLICATION <br />The County Board of <br />County, Minnesota, has reviewed the application <br />of dated , 20�, for the <br />conveyance for an authorized public use of certain tax-forfeited land described therein. The counry board <br />recommends that this application be: rejected granted <br />Signature (for the County Board) Date <br />CERTIFICATIONOF COUNTY AUDITOR OR LAND COMMISSIONER <br />I have talcen the necessary steps required by Minnesota Statutes to prepare the herein described tax-forfeited <br />land for conveyance for an authorized public use. <br />Signature of County Auditor or Land Commissioner Date <br />OFFICE OF THE COMMISSIONEROF REVENUE <br />St. Paul, Minn., > ZQ <br />Upon due consideration of this application, it is ordered that it is hereby: rej ected granted <br />Commissioner of Revenue <br />E� <br />