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State of Maryland
County of ______________ (or City of Baltimore), to wit:
On this ____ day of ______________, 20___, before me, the undersigned officer,
personally appeared _____________________________ [name of person(s) who make
acknowledgement on behalf of corporation], who acknowledged himself to be the
______________________ [title of officer or agent] of ______________________
[name of corporation], a corporation, and that he/she/they, as such
______________________ [title], being authorized to do so, executed the foregoing
instrument for the purposes therein contained, by signing the name of the corporation
by himself/herself/themselves as ______________________ [title].
In witness whereof, I hereunto set my hand and official seal.
[Notary Seal] [Signature of Notary Public]
[Printed Name of Notary Public]
Notary Public
My Commission Expires: ______________
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