MO Acknowledgment-Individual 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 _______________________________, known to me to be the same person(s) described in and who executed the within instrument, and acknowledged to me that ______ executed the same for the purpose therein stated.

________________________________

Notary Public

My Commission Expires: ____________

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