Notary's Certificate of Acknowledgement

State of _________________________________________________________

City/County of ___________________________________________________

On ________________________, before me, __________________________

         (Date)                                                                    (Notary’s name)

Personally appeared, _____________________________, and proved to me

                                                (Printed name of signer)

On the basis of satisfactory evidence of identification ____________________

                                                                                                 (Type of ID provided)

To be the above-named person who signed the foregoing instrument.

 

WITNESS my hand and official seal       ________________________________

                       (Seal)                                             (Notary signature)

 

My commission expires on _______________________

                                                     (Date)