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CORPORATE PROPERTY OWNER SIGNATURE BLOCK AND ACKNOWLEDGMENT
__________________________________________________
[Insert Company’s or Trust’s Name]
By: __________________________________________________
[Signature of Authorized Officer, or Trustee]
Its: __________________________________________________
[Insert Title]
Dated:
STATE OF______________________)
) ss.
COUNTY OF____________________)
The foregoing instrument was acknowledged before me, this___________ day of _____________, 20____ by
__________________________________,______ ____________________________________________
[Insert Signor’s Name] [Insert Title]
___________________________________, _________________________________________________an,
[Name of Company or Trust] [Insert State of Incorporation, if applicable]
And who being authorized to do so, executed the foregoing instrument on behalf of said entity for the
purposes stated therein.
My Commission Expires: ___________________
________________________________________ ______________________________________
Printed Name of Notary Signature of Notary
ALTERNATE: Use the following acknowledgment only when a second company is signing
On behalf of the owner:
STATE OF_________________)
) ss. (Seal)
COUNTY OF_______________)
The foregoing instrument was acknowledged before me, this_______ day of ______________, 20____ by
_________________________________________, who acknowledges himself/herself to be
[Insert Signor’s Name]
____________________________________________, of _____________________________________
[Title of Office Held] [Second Company]
As _____________________________________ for ________________________________, and who being
[i.e. member, manager, etc.] [Owner’s Name]
Authorized to do so, executed the foregoing instrument on behalf of said entities for the purposes stated
therein.
My Commission Expires_________________
_____________________ _________________________________
Printed Name of Notary Signature of Notary
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