STATE OF TENNESSEE
COUNTY OF _____________
On this _____ day of _________, 20_____, before me, personally appeared ________________________________________, to me known to be the person described in and who executed the foregoing instrument, and who acknowledged the execution of same to be his free act and deed.
IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal.
_____________________________________
NOTARY PUBLIC
My Commission Expires:
_____________________________________
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