WA Acknowledgment-Representative Capacity 1



COUNTY OF _________________ )

I certify that I know or have satisfactory evidence that _____________________________ is the person who appeared before me, and said person acknowledged that _____ signed this instrument, on oath stated that _____ was authorized to execute the instrument and acknowledged it as _______________________ of ___________________________________________ to be the free and voluntary act of such party for the uses and purposes mentioned in the instrument.

Dated: _________________________


Notary Public

Printed Name: ______________________

My appointment expires: ______________

Representative Capacity

No guidelines are available for this form at this time.