WA Acknowledgment-Corporation 1

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WA Acknowledgment-Corporation 1

Form Document
10/12/2005
V 1

STATE OF WASHINGTON)

) SS.

County of @)

I certify that I know or have satisfactory evidence that @ is/are the person(s) who appeared before me, and said person(s) acknowledged that he/she/they signed this instrument, on oath stated that he is/she is /they are authorized to execute the instrument and acknowledged it as the @ of @ to the free and voluntary act of such party for the uses and purposes mentioned in this instrument.

DATED: @

____________________________________________________

Name (typed or printed): @ __________________________

NOTARY PUBLIC in and for the State of @ _________

Residing at @ _______________________________________

My appointment expires: @ __________________________

No guidelines are available for this form at this time.

No guidelines are available for this form at this time.