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SI/We certify that all information provided in this application is <br /> true and correct to the best of my/our knowledge . I/We authorize the <br /> City of Elk River and the Finance Committee to check credit <br /> references and verify financial and other information. I/We agree to <br /> provide any additional information as may be requested by the City <br /> and the Finance Committee . <br /> DATE /n--,.,76,-- n& <br /> Applicant Name Rel,C (T4eoi /) Tear/1eBy <br /> Jit./-4_ <br /> /1-t7(2 <br /> • <br /> • <br /> -5- <br />