STATE OF TENNESSEE
COUNTY OF _____________
On this _____ day of ____________________, 20_____, before me, appeared ________________________________________, to me personally known (or proved to me on the basis of satisfactory evidence), who, being by me duly sworn (or affirmed) did say that he is the ___________________________________________ of _____________________________________, and that the seal affixed to said instrument is the corporate seal of said corporation (or association), and that said instrument was signed and sealed in behalf of said corporation (or association) by authority of its Board of Directors (or Trustees) and said ________________________, acknowledged said instrument to be the free act and deed of said corporation (or association).
WITNESS my hand and Notarial Seal at office the day and year above written.
My Commission Expires:
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