STATE OF MISSOURI)
)ss.
COUNTY OF ______________)
On this ________ day of __________________ in the year 20___, before me, a Notary Public in and for said state, personally appeared _______________________________, ____________________________, of ______________________________________, a __________________ corporation, personally known by me to be the person who executed the within instrument, in behalf of said corporation and acknowledged to me that _____ executed the same for the purposes therein stated.
_______________________________
Notary Public
My Commission Expires: __________
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