Instructions For Form 133.8 - Power Of Attorney (Page 3 of 3) in pdf

Instructions For Form 133.8 - Power Of Attorney Page 3

Form

133.8

ACKNOWLEDGMENT

CORPORATE/LLC/ENTITY WITH DUAL SIGNATURE REQUIREMENT

STATE OF

______________________

COUNTY OF

______________________

Before me, the undersigned authority, personally appeared _________________________ and

___________________________, known to me to be the persons whose names were subscribed

in my presence to the foregoing instrument and to be the ________________________________

and __________________________ of _____________________________________________,

and who acknowledged to me that the instrument was executed for the purpose and considerations

therein expressed.

Subscribed and sworn to before me the _______ day of ______________, 2_____.

Notary Public in and for the County of

State of

(NOTARY SEAL)

My commission expires:

INDIVIDUAL/PARTNERSHIP

STATE OF

______________________

COUNTY OF

______________________

Before me, the undersigned authority, personally appeared ______________________________ ,

known to me to be the person whose name was subscribed in my presence to the foregoing

instrument, and who acknowledged to me that the instrument was executed for the purpose and

considerations therein expressed.

Subscribed and sworn to before me the _______ day of ______________, 2_____.

Notary Public in and for the County of

State of

(NOTARY SEAL)

My commission expires:

A-17A

8-10-2003

Instructions For Form 133.8 - Power Of Attorney Page 3