NV Acknowledgment-Individual 1

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NV Acknowledgment-Individual 1

Form Document
09/30/2005
V 1

STATE OF NEVADA)

) ss.

COUNTY OF __________________)

On ____________________________, 20_____ before me, _________________________________________, a Notary Public, personally appeared ______________________________________________________, personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her authorized capacity, and that by his/her signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument.

WITNESS my hand and official seal.

______________________________________ Notary Public in and for Said County and State

[SEAL]

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