AFFIRMATION Pursuant to NRS 239B.030 The undersigned does hereby affirm that the preceding _______________ _________________________________________________________________ (Title of Document) filed in District Court Case number ________________________________ Does not contain the social security number of any person. -ORContains the social security number of a person as required by: A. A specific state or federal law, to wit: _____________________________________________ (State specific law) -orB. For the administration of a public program or for an application for a federal or state grant. _____________________________ Signature ______________________________ Print Name ______________________________ Title ________________ Date American LegalNet, Inc. www.FormsWorkflow.com