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NAME
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____________
IDENTIFICATION
____________
____________
Known to me to be the same persons who executed the foregoing instrument and they
acknowledged to me that the same is their own free and voluntary act and deed and of the
corporations herein represented.
This instrument refers to a (title of document) and consists of ___ pages including the
page on which this acknowledgment is written and signed by the parties and their
instrumental witnesses on each and every page thereof.
WITNESS MY HAND AND SEAL on the date and at the place above written.