STATE OF ______________
County of ________________
On this __________day of _______, 20_____, before me a Notary Public personally appeared A B, to me personally known, who, being by me duly sworn (or affirmed) did say that he is the president (or other officer or agent of the corporation), of (describing the corporation), and that the seal affixed to foregoing instrument is the corporate seal of said corporation (and that said instrument was signed and sealed), in behalf of said corporation by authority of its board of directors, and said A B acknowledged said instrument to be the free act and deed of said corporation.
In Testimony Whereof, I have hereunto set my hand and affixed my official seal the day and year last above written.
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Notary Public: _________________________
My Commission Expires: _________________
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No guidelines are available for this form at this time.