Affidavit

AFFIDAVIT OF U.S. CITIZENSHIP

OF

(NAME OF LIMITED PARTNERSHIP)

State of )

) ss.:

County of )

I, (Name), of (Physical residence address, city, and state), being duly sworn, depose and say:

1. That I am a general partner in (Name of Limited Partnership), a limited partnership organized and existing under the laws of the State of ______ with offices at (Business address) (hereinafter called the “Partnership”), in evidence of which formation a true copy of the Articles of Limited Partnership dated ( Date ) is filed herewith (or has previously been filed with the Maritime Administration). [Evidence of continuing U.S. citizenship status, including amendments to said Articles of Limited Partnership, should be filed at least 45 days prior to the annual documentation renewal date for vessel owners. Other parties required to provide evidence of U.S. citizenship status must file within 30 days after the annual meeting of the Partnership or annually, within 30 days after the original affidavit if there has been no meeting of the Partnership prior to that time.];

2. That I am authorized by and in behalf of the Partnership to execute and deliver this Affidavit of U.S. Citizenship;

3. That the Partnership is a Limited Partnership with at least one General Partner and one Limited Partner and that all General Partners are U.S. Citizens;

4.That the partnership information upon which (Name of Partnership) relies to establish that 75% of the ownership and control is vested in Citizens of the United States, is as follows: ________________________________________________________________________

Name of Partner Type of Partner Date & Place of Birth Partnership Interest

Name General or Limited ( %)

( %)

Total Partnership Interest 100%

______________________________ __________________________________________

and that each of said individual partners is a Citizen of the United States by virtue of birth in the United States, birth abroad of U.S. citizen parents, or as otherwise authorized by law, except (give name and nationality for any above identified partners who are not U.S. Citizens). Note: Include applicable citizenship information of General Partners as well as citizenship information needed to establish that 75% of the interest in the Partnership is held by U.S. Citizens. The information for such Partners may be included in the present affidavit or attached in separate affidavits.

5. That 75% of the interest in the Partnership, as established by the information herein before set forth, is owned and controlled by Citizens of the United States; that the title to 75% of the shares of the Partnership is vested in Citizens of the United States free from any trust or fiduciary obligation in favor of any person not a Citizen of the United States; that such proportion of the voting power of the Partnership is vested in Citizens of the United States; that through no contract or understanding is it so arranged that more than 25% the voting power of the Partnership may be exercised, directly or indirectly, in behalf of any person(s) who is not a Citizen of the United States; and that by no means whatsoever, is any interest in the Partnership in excess of 25% conferred upon or permitted to be exercised by any person(s) who is not a Citizen of the United States; and

6. That the affiant has submitted all of the necessary documentation required under 46 C.F.R. ' 356.13 in connection with this Affidavit of U.S. Citizenship for the vessels herein identified.

7. That affiant has carefully examined this affidavit and asserts that all of the statements and representations contained therein are true to the best of his knowledge, information, and belief.

(Name and title of affiant)

.

(Signature of affiant) Date

Penalty for False Statement: A fine or imprisonment, or both, are provided for violation of the proscriptions contained in 18 U.S.C. 1001 (see also, 18 U.S.C. 286, 287 and 46 App. U.S.C. §12122).

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