New York State Notary Acknowlegment

New York State Notary Acknowlegment

County of

On The Day

Year

before me, the undersigned, personally appeared (enter a value in the following field) personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument.

Notary Public Signature

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Title or Office

My commission expires

New York State Notary Acknowlegment

New York State Notary Acknowlegment

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