JURAT

A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.

State of California

County of

Subscribed and sworn to (or affirmed) before me on this ___day of__________________,20__

by _______________________________________________________________________,

proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me.

____________________________________

Signature (seal)

OPTIONAL INFORMATION

Document Identification:

Document name or Type ______________________________________________________________________ ____________________________________________________________________________________________

Date of Document: __________________

Number of Pages_________

Document in a Foreign Language Yes / No

Language: ______________________________________________

Identification of signer: ____________________________________________________________________

______________________________________________________________________________