PA Acknowledgmen - Individual 2

State of                     
 
County of                     
 
On this, the      day of             , 200__, before me, the undersigned officer, personally appeared           , known to me (or satisfactorily proven) to be the person whose name is/are subscribed to the within instrument, and acknowledged that he/she/they executed the same for the purposes therein contained.
 

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

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