Notary
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State of: _______________________
County of: ______________________
On ____/____/______, before me,
______________________________,
Personally appeared,
_____________________________,
[__] Personally known to me
OR
[__] Proved to me on the basis of satisfactory evidence to be
the person(s) whose name(s) is/are subscribed to the within instrument and has hereby acknowledged to me that he/she/they have executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument.
Witness my hand and official seal
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Notary Signature
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Print Name
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