DS9 Document EFTA00809872

• IS ‘ lat. IN 1St knE1, ST. CROIX 116 King Street Frederiksted. VI 00840 (340)773.6499 FAX (340) 773-7701 ST. THOMAS 8000 Nisky Shopping Center, Suite 620, St. Thomas, VI 00802 (340)714-1700 FAX (340) 777-1103 Economic Development Authority www.USVIE0A.org CERTIFICATION OF TRUTH (To be filled out by a duly authorized representative of the entity in support of the application for Virgin Islands Economic Development Commission ("VIEDC")tox incentive benefits.) Examples of authorized signatories: CORPORATION - an officer (President/Secretary/Treasurer or Chief Financial Officer) or a non-officer with written signatory authority; LLC -a Manager; PARTNERSHIP (General Partnership/LPALP/LLLP) - a General Partner, but not a Limited Partner NAME OF VIEDC APPLICANT: Please irditatoubtther entiry conduts transxts busiress uneen &acts ore (d/b/a'. Under penalties of perjury I, (Print), hereby certify that I have examined this application and accompanying documents submitted for consideration before the VIEDC and to the best of my knowledge and belief, they are true, accurate and complete. If information submitted changes, I understand that I am obligated to inform the VIEDC. SIGNATURE: TITLE: DATE: EMAIL: STATE OF ACKNOWLEDGMENT COUNTY OR DISTRICT OF ) SS: On this day of 20 before me the undersigned officer, personally appeared , known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that he/she is authorized to execute same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notary Public Commission Expires: The VIEDC reserves the right to request the entity's organizational agreement, operating agreement and resolutions duly adopted to authorize and empower the herein named signatory to negotiate, enter into and execute, in the name and on behalf of the entity, any applications, agreements, documents, instruments, certificates and other commitments and obligations that he/she deems or believes to be advisable and in the best interest of the entity. A photocopy, electronic, or similar copy of this Certification of Truth shall be considered as effective and valid as the original. (Rev. 01/2017) EFTA00809872