STATE OF ________________
COUNTY OF ______________
I, the undersigned, a Notary Public in and for said County in said State, hereby certify that _______________________________, whose name is signed to the foregoing, and who is known to me, acknowledged before me on this day that, being informed of the contents of the foregoing, ____________________________ executed the same voluntarily on the day the same bears date.
Given under my hand and official seal this the _____ day of _____________, 20______.
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