ACKNOWLEDGMENT
STATE OF _________________}
COUNTY OF _________________}
On _________________ before me, ___________________________________________________
(here insert name and title of the officer)
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 PENALTY OF PERJURY under the laws of the State of _____________ that the
foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature: __________________________________(Seal)
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.
