upon or occupy, the lands to be opened to settlement by the President's
proclamation of August 19, 1893, in violation of the requirements of
said proclamation; that I desire to make entry for the purpose of actual
settlement and cultivation, and not for the benefit of any other person,
persons, or corporation; that I will faithfully and honestly endeavor to
comply with all the requirements of law as to settlement, residence, and
cultivation necessary to acquire title to the land I may select; that I
am not acting as agent of any person, corporation, or syndicate in
entering upon said lands, nor in collusion with any person, corporation,
or syndicate to give them the benefit of the land I may enter, or any
part thereof, or the timber thereon; that I do not apply to enter upon
said lands for the purpose of speculation, but in good faith to obtain a
home for myself; and that I have not, directly or indirectly, made and
will not make any agreement or contract in any way or manner with any
person or persons, corporation, or syndicate whatsoever by which the
title which I may acquire from the Government of the United States
should inure in whole or in part to the benefit of any person except
myself.

----------.

I certify that the foregoing declaration was made and subscribed before
me this ---- day of ----, 1893.

-------- ----------, _Officer in Charge_.

* NOTE.--If the party has made a homestead entry since March
2, 1889, but has failed or is unable to perfect title to the land
covered thereby because of a valid adverse claim or other invalidity
existing at the date of its inception, strike out the words "made or"