STATE OF MISSOURI)
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 person who executed the within instrument as _______________ in behalf of ___________________________, and acknowledged to me that _____ executed the same for the purposes therein stated.
________________________________ Notary Public
My Commission Expires: ___________
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