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PETITION FOR STANDING IN A CONTESTED CASE HEARING <br /> (Page 2 of 2) <br /> D. Are you a person or persons descended from native Hawaiians who inhabited the <br /> Hawaiian Islands prior to 1778, who practiced those rights which were customarily and <br /> traditionally exercised for subsistence, cultural, or religious purposes`' <br /> Yes No <br /> If the answer is "yes", please submit any genealogical evidence and historical evidence <br /> showing the exercise of those rights to support your statement: <br /> etitiioner's Signature <br /> STATE OF HAWAII } <br /> } SS. <br /> COUNTY OF HAWAII } <br /> f On this day of , 209 , before me personally appeared <br /> -� r , to me known to be the person described in and who executed <br /> the foregoing instrument, and acknowledged that he executed the same as his free act and deed. <br /> ,�gtiti�rrrnrarrrfr � � � <br /> 000P <br /> �� •`�`�iJ, Notary Public, State Viawau <br /> 'ST E <br /> AT _ <br /> OF <br /> i. HAWAII My commission exl}Ires: �N <br /> NOTARY , <br /> ,PUBLIC <br /> �$i.�y <br /> %,••" ...... \ ; <br /> %,,ss'On NOVACb <br /> �%��'�: <br /> Appendix A <br />