STATE OF WASHINGTON )
ss.
COUNTY OF _________________ )
I certify that I know or have satisfactory evidence that _____________________________ is the person who appeared before me, and said person acknowledged that _____ signed this instrument, on oath stated that _____ was authorized to execute the instrument and acknowledged it as _______________________ of ___________________________________________ to be the free and voluntary act of such party for the uses and purposes mentioned in the instrument.
Dated: _________________________
____________________________________
Notary Public
Printed Name: ______________________
My appointment expires: ______________
Representative Capacity
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