STATE OF ___________________
COUNTY OF _________________
PROBATE
Personally appeared before me _______________________ (name of witness), the subscribing witness, and certified to me under oath or by affirmation that they are not a party to or beneficiary of the transaction, they signed the record as a subscribing witness, and they either witnessed ____________________ (name of grantor or principal) sign the record, or witnessed __________ (him/her) acknowledge _______ (his/her) signature on the record.
________________________________________________
Witness (printed name)
__________________________________________
Notary Public for ______________________
My Commission Expires:
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