Form U-Sb - Uniform Surety Bond Form - Securities Departmnt (Page 4 of 4) in pdf

Form U-Sb - Uniform Surety Bond Form - Securities Departmnt Page 4

FORM U-SB

PAGE 4 OF 4

ACKNOWLEDGMENT OF PARTNERSHIP

STATE OF _______________________________)

COUNTY OF _____________________________)

On this ______ day of __________________________, 20 ______, before me personally

appeared ______________________________________________________, to me known to be a

member of the firm executed the foregoing instrument, and he acknowledged to me that he executed the

same as and for the act and deed of said firm,

(NOTARIAL SEAL)

_____________________________________

Notary Public

_____________________________________

County, _____________________________

My commission expires _________________

ACKNOWLEDGMENT OF CORPORATION

STATE OF _______________________________)

COUNTY OF _____________________________)

On this ____ day of __________________________, 20 ___, before me personally came

_____________________________________, and says he is the ______________________________,

Principal heretofore names: that he executed the instrument for and in its behalf, by authority of its Board

of Directors, and affixed its seal thereto.

(NOTARIAL SEAL)

_____________________________________

Notary Public

_____________________________________

County, ______________________________

My commission expires _________________

NOTE:

A true copy of the applicable “Power of Attorney” must be attached hereto where the

Bond is subscribed to by an Attorney if Fact.

Form U-Sb - Uniform Surety Bond Form - Securities Departmnt Page 4