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       INMATE'SDECLARATION


       I,   JLWrgl S &t/cT&MS                     am the iapplicani / petitioiief (circle one) and
being presentlyincarcerated in TDxC^//.^>f/ir2 tjLMEC'•> declare imdler penalty of
perjurythat, according tomy belief, the facts stated inthe above application are true and correct.

                                                    Signed on ^f/A^




                                                  17
