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SZ'ATE OF ~np ) •
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GOUNTY OF $1'. j,I~IE ) '
IIEFOItE ME, the undersigned authority, personally appeared
, to me
we ~own to Q~ e in iv ua s escri n an who executed
the foregoinq instrument, ~nd ~acknowledqed before me that
executed the same freely and volurr~arily tor_tlie purposes
t erein expressed.
WITIIESS my~hand and of f icial sc:~I, at the State anc~ County
aforesaid, this day of ~b~ry , 197~.
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