_________, being duly sworn, says that —he is the general partner [or "one of the general partners"] named in the foregoing certificate of limited partnership signed by _________ and _________ and _________; that the amount [state amount and whether in "money" or "other property at its cash value"] specified in that certificate to have been contributed by _________, the special partner to the common stock [or "by each of the special partners named in it"] has been actually and in good faith contributed and applied and paid into the firm.

Subscribed and sworn to, etc.

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