STATE OF)
)ss.
County of)
The foregoing instrument was acknowledged before me this _____ day of _________, 20_____ by _______________________________________ (Name of officer or agent, title or officer or agent) of (Name of corporation acknowledging) a (State or place of incorporation) corporation, on behalf of the corporation.
____________________________________
(Signature of person taking acknowledgment)
(Title or rank)
(Serial number, if any)
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