MO Acknowledgment-Corporation 1

STATE OF MISSOURI)

)ss.

COUNTY OF ______________)

On this ________ day of __________________ in the year 20___, before me, a Notary Public in and for said state, personally appeared _______________________________, ____________________________, of ______________________________________, a __________________ corporation, personally known by me to be the person who executed the within instrument, in behalf of said corporation and acknowledged to me that _____ executed the same for the purposes therein stated.

_______________________________

Notary Public

My Commission Expires: __________

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