NOTARY

State of [Your State]

County of [Your County]

On this [Day] day of [Month], [Year], before me, [Notary Name], a Notary Public in and for said County and State, personally appeared [Your Name], who 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.

I certify under PENALTY OF PERJURY under the laws of the State of [Your State] that the foregoing paragraph is true and correct.

WITNESS my hand and official seal.

Date: [Date]

Notary Public, [Your State]

My Commission Expires: [Expiration Date]