Assignment - Joint Ownership With Right Of Survivorship Page 3

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___________________________________________ Spouse
We, ______________________________________________________________________
________________________________________________________________________________
____________________________________________________________
Hereby acknowledge that we witnessed:
______________________________________________________________________
Who is/are known to us personally, sign the above assignment on:
______________________________________________________________________
In our presence and that:
______________________________________________________________________
______________________________________________________________________
Acknowledged to us and it appeared to us that he/she/they signed said assignment freely and
voluntarily. We signed our names as witnesses in the presence of and at the request of said assignor(s).
Dated this _____________________ day of _____________ (month), _____ (year).
____________________________________
Witness
____________________________________
Witness
____________________________________
Witness
STATE OF: _______________________________________________________________.
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