STATE OF <State>, COUNTY OF <County>, ss.:
On this day, personally appeared before me
to me known to be the person(s) described in and who executed the within and foregoing instrument, and acknowledged that he/she signed the same as his/her voluntary act and deed, for the uses and purposes therein mentioned.
Witness my hand and official seal hereto affixed
this ______ day of ____________, _________.
Notary Public in and for the State of _________________.
My commission expires _______________.