Satisfaction Of Lien Claim Page 2

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Return (enclosed self-addressed stamped address)
STATE OF
)
I hereby certify that on this day, before me, an officer duly authorized to
administer oaths and take acknowledgments, personally appeared
COUNTY OF
)
known to me to be the
President and
respectively of
, the corporation in whose name the
foregoing instrument was executed, and that
severally acknowledged executing the same for such corporation,
freely and voluntarily, under authority duly vested in them by said corporation, and that the seal affixed thereto is the true corporate
seal of said corporation, and that an oath was not taken. (Check one:
Said persons are personally known to me.
Said persons
produced the following type of identification:
.
NOTARY RUBBER STAMP SEAL
Witness my hand and official seal in the County and State last aforesaid this
day of
, A.D.
(year)
Notary Signature
Printed Name
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