VT Acknowledgment-Corporation 1

STATE OF VERMONT

COUNTY OF ___________________, SS.

At __________, in said County, on this _________ day of __________, 20______, _________________________________, duly authorized agent of ___________________

(Name and Title) (Corporation)

personally appeared and he/she acknowledged this instrument, by him/her sealed and subscribed, to be his/her free act and deed of ________________________________.

(Corporation)

Before me, _________________________________

Notary Public

My commission expires: 2/10/03

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