PA Acknowledgment-Public Officer, Trustee, Administrator, Guardian and Executor 1

State of ______________________

County of ____________________

On this, the _____ day of ________________________, 20_____, before me, the undersigned officer, personally appeared _______________________________, of the State (County or City as the case may be) of ____________________________ known to me (or satisfactorily proven) to be the person described in the foregoing instrument, and acknowledged that he executed the same in the capacity therein stated and for the purposes therein contained.

In witness whereof, I hereunto set my hand and official seal.

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Title of Officer

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