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PETITION FOR STANDING IN A CONTESTED CASE HEARING <br /> (Pane'of?) <br /> D. Are you a person or persons descended from.native;Hawaiians who inhabited the <br /> Hawaiian Islands prior to 17.78, who practiced those rights which were customarily and <br /> traditionally exercised for subsistence, cultural, or religious purposes? <br /> Yes No x <br /> Tf the answer is"yes", please.submit any genealogical evidence and historical evidence. <br /> showing the exercise of those ri'lits to support your stateinent: <br /> Petitioner's Signature <br /> STATE OF HAWAII ) <br /> S.S. <br /> COUNTY OF HAWAII ) <br /> .On this _day .of f ?o_L, before mepersonally appeared <br /> —511 to(zt P, G1 +`� ,to me known to be the person described in and who executed <br /> the foregoing instrument; and acknowledged That he executed flze same as his tree act and deed. <br /> '4 � . <br /> Notary blic, St e' of Hawaii <br /> My commission expires: <br /> DESTINY HULSEV <br /> Notary Public•.Arkansas <br /> Clark County <br /> Commission x 12713984' <br /> my Commission Expires Feb 26, 2037 <br /> qW <br /> Appendix A <br />