Assignment Of Cash Collateral Form - 2014 (Page 2 of 2) in pdf

Assignment Of Cash Collateral Form - 2014 Page 2

____________________________ ____

_________________________________________

Title

Officer’s Title

ACKNOWLEDGMENT IN AN INDIVIDUAL CAPACITY

State of

_______________________

County of

_______________________

This instrument was acknowledged before me on ______________________________ (date) by

_________________________________________ (name(s) of person(s))

____________________________________

Signature of Notarial Officer

Name: ______________________________

Title: ______________________________

(Seal)

My commission expires: _______________

ACKNOWLEDGMENT IN A REPRESENTATIVE CAPACITY

State of

_________________________

County of

_________________________

This instrument was acknowledged before me on ___________________(date) by

_____________________________________ (name(s) of person(s))

as ___________________________________ (type of authority, e.g., officer, trustee, etc.) of

______________________________________________________________________________

(name of party on behalf of whom instrument was executed.)

___________________________________

Signature of Notarial Officer

Name: _____________________________

Title: _____________________________

(Seal)

My commission expires: _______________

Note: When you provide a check as payment, you authorize the State of New Mexico to either use information from your check to make

a one-time electronic fund transfer from your account or to process the payment as a check transaction. Please be advised that payments

will be drafted from your account immediately upon receipt.

Rev 12-22-2014

Assignment Of Cash Collateral Form - 2014 Page 2