ACKNOWLEDGMENT
|
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
County of
On ___________________________ before me, , Notary Public,
Personally appeared_________________________________________________________________________ ________________________________________________________________________________________,
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under the PENALTY OF
PERJURY under the laws of the State of
WITNESS my hand and official seal.
__________________________________
Notary public Signature
(Notary Seal)
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OPTIONAL INFORMATION OF DOCUMENT
IDENTIFICATION
Document Name or Type: ___________________________________________________________________
________________________________________________________________________________________
Date of document:__________________
Number of Pages:_________
Document in a Foreign Language: Yes
/ No
Language:
________________________________________________
Identification of Signer: _____________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________