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Part 1201 up to date from eCFR as of Jun 16, 2025; last amended Oct 7, 2024.

Appendix IV to Part 1201—Sample Declaration Under 28 U.S.C.1746

Declaration

I, ___________, do hereby declare:

I declare under penalty of perjury under the laws of the United States of America that the foregoing is true and correct.

Executed on
Date
Signature