Indiana Durable Power Of Attorney Page 7

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Notary Acknowledgement (Must be completed by Notary)
State of
County of
Subscribed,
Sworn and acknowledged before me by
, the
Principal, and subscribed and sworn to before me by
,
witness, this
day of
.
Notary Signature
Notary Public
In and for the County of
State of
My commission expires:
Seal

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