I have never been convicted of an offense that constitutes the crime of
"arson and related offenses" under 18 Pennsylvania C.S. 3301 or
any similar offense under any Federal or state law. I hereby
certify that the statements contained herein are true and correct to the
best of my knowledge and belief. I understand that if I knowingly
make any false statement herein, I am subject to penalties prescribed
by law, including, but not limited to, a fine of at least $1,000.
Do you agree in whole with the above statement.