State of [State Name], County of [County name]
On this day, appeared before me in person
____________________________________________________________,
to me known to be the person(s) described in and who performed the within and preceding document, and accepted that he/she signed the same as his/her voluntary act and action, for the uses and purposes mentioned within.
Witness my hand and official seal hereto affixed
this ______ day of ____________, _________.
__________________________________________
Notary Public in and for the State of _________________.
My commission expires _______________.
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