STATE OF NEVADA)
) ss.
COUNTY OF _____________________)
ON ____________________________, 20_____ before me, the undersigned, a Notary Public in and for said State, personally appeared _______________________________, known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument, as the Attorney-in-Fact of ______
__________________________________________________ and acknowledged to me that ___ he subscribed the name of _________________________________________
thereto as principal ______ and h _____ own name as Attorney-in-Fact.
WITNESS my hand and official seal.
_______________________________
_______________________________ NAME (TYPED OR PRINTED) Notary Public in and for said State
[SEAL]
STATE OF NEVADA,)
) ss.
COUNTY OF _______________________)
On this ________ day of ____________________, A.D. 20_____, personally appeared before me, a notary public, in and for ________________________ County, ___________, known (or proved) to me to be the person whose name is subscribed to the within instrument, as the attorney-in-fact of ___________________
___________________________________________, and acknowledged to me that ___ he subscribed the name of ____________________________________________
thereto as principal, and h _____ own name as attorney-in-fact, freely and voluntarily and for the uses and purposes therein mentioned.
_____________________________________
Notary Public in and for said County and State
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