ND Acknowledgment-Individual 1

STATE OF NORTH DAKOTA)

) SS.

COUNTY OF _______________________)

On this ____ day of _________________, 20_____, before me, personally appeared ______________________________________________________, known to me to be the person__ who __ described in, and who executed the within and foregoing instrument, and severally acknowledged that _____ executed the same.

____________________________________________

Notary Public

______________________________ County, N.D.

My commission expires:

___________________________, 20_____

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