Owner'S Dedication Block Sample Forms Page 3

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EXAMPLE FORM
(When owner is an individual or individuals)
WITNESS my (or our) hand in the City of _________, Texas, this (number) day of (month) , (year) .
(signature of owner or owners)
(name(s) to be printed)
(When owner is a company or corporation)
IN TESTIMONY WHEREOF, the (name of company) has caused these presents to be signed by
(name of president or vice-president), its (president or vice-president), hereunto authorized, attested by its
Secretary (or authorized trust officer), (name of secretary or authorized trust officer), and its common seal
hereunto affixed this (number) day of (month), (year).
______________________________________________
(Name of company)
By:
(signature of president or vice president)
(name to be printed)
Attest:
(signature of secretary or authorized trust officer)
Title
(affix corporate seal)
Note: All owners' signatures shall be acknowledged by a Notary Public

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