WA Acknowledgment-Representative Capacity 1

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WA Acknowledgment-Representative Capacity 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 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

No guidelines are available for this form at this time.