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ACKNOMLEOGMENTS
, FOR USE IN ALL STATES EXCEPT SOU7H CAROIINA
INDIVIDUAL FORM " ~
STATE OF Fta ~e ~ aA
;
COUNTY OF s~- ~CUC/F s
1, ~?d~.~[ L~ , hereDy certify thet on this day betore ~ne
an ottlcer duly auti~orized in the state and county aforesald to take acknowledgn~ants, pe~sonaliy
aDPsarad CuRT/S lN. ~/AMES , to n~e k~own to Oe the person descrl0ed In and
wAO executed the toregoing instru~nent and acknowledged bsfore ~ne tAe due executlon and delivery
thereot tor t~s pu~pose therein stated. ~
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IN WITNESS NMEREOF, 1 have hsreunto'set Ty ha~d and ottlclal saal, thls ta~ .
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aay or Au~ usT , i9 72 r•`_.-a,
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F lE0 ANO RECORDEp ' ~ • ' ~ =
WCIE COUNTY fU. ,,~0 ° ~ t ~ ~ 1 ~ : _
i !lOCE~ POITRAS r M ~ ' ' _
' CLERK C~3~UIT COURT Notary PuD I 1 c 10~ other t 1 t I~ ~
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~ REC6RD VER!FIED~~ - •:1 ,
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~ My Commtsston Explres:
234802 ~
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' CORPORATION FORM ~
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STATE OF '
COUNTY OF '
1, , Aereby csrtity tAa n thls day Osto~e ~ne
an ottlcer duly authori=ed to ake ack~owledgn~ents, ps~aonally app red
to ~ns known and kno to be tha person descr ed in anC who executed the foregoing
instru~nent es ot , a corporation, and • 's
acknowledged to ms that he executed and deli red h instrument as such otticer in the na~ne and on ~
behalt ot sa10 corporatton, Deing duly auChoriz so to do. ~
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IN WITNESS WHEREOF, I have he unto aet n~y han and otticial seal, thls tha
day ot 19~..~.
Nota~y PuDlit lor other t~tl
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