All Purpose Acknowledgement

State of

County of

On___________________________, before me, _______________________________________,

(notary)

(date)

personally appeared, _____________________________________________________________,

(signers)

personally known to me  -- OR --                                                                                 

proved to me on the basis of satisfactory evidence to be the person(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 authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument

WITNESS my hand and official seal

_____________________________________________

(notary signature)

OPTIONAL INFORMATION

_____________________________________________________________________________________

The information below is not required by law. However, it could prevent fraudulent attachment of this acknowledgement to an unauthorized document.

CAPACITY CLAIMED BY SIGNER (PRINCIPAL)                     DESCRIPTION OF ATTACHED DOCUMENT

Individual

Corporation Officer

___________________________________

                         title(s)

Partner(s)

Attorney-In-Fact

Trustee(s)

Guardian/Conservator

Other: ______________________________

____________________________________

____________________________________

SIGNER IS REPRESENTING:

Name of Person(s) OR Entity(ies)

____________________________________

____________________________________

_____________________________________

             Title or Type of Document

_____________________________________

                    Number of Pages

_____________________________________

                    Date of Document

_____________________________________

                            Other

Right Thumbprint

of Signer

(if required)

(seal)