STATE OF ________________
COUNTY OF ______________
I, the undersigned, a Notary Public in and for said County in said State, hereby certify that ____________________________________________, whose name as ___________________________ of ___________________________________ a _____________________ corporation, is signed to the foregoing, and who is known to me, acknowledged before me on this day that, being informed of the contents of the foregoing, ________________________________ as such officer and with full authority executed the same voluntarily for and as the act of said corporation on the day the same bears date.
Given under my hand and official seal this the _____ day of _________, 20 ______.
___________________________
Notary Public
No guidelines are available for this form at this time.