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~~~~~ ~` ~ OEPARTMEN? OF STATE
• • FOREIGN SERVICE OF TME UNITEO STATES OF AYERICA
Certificate of Acknowledgment of F~ecution of an Instrument
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~c.~~a~~ o~"ia~y ---«~~ M_---------------
~Provir-ce of Neple~ ~ ~
~:y~_____________~_ _________ -
_~~h(., ~~' ~P~`Odl~ oter v~ ~°°)
Consulet~ Generei o~ th~ ~~
n i!'T I~~Aic~e~litie~l dhWao) ~
•____-_ -------~~~------- "'
(Nm ot loc~ a~iee a~~ -
I, -----1°~ct~ael J_~__Gui.gnard --------------------- Consul. ----------•----------•-•--•--
---- -, -•--------------------••-
o! the United Statsa ot America at --------~~!~~i--~~~X~------------------------------------------------
duly commiaaioned and qualified, do hereby certity that on this ______ ~~h___________________
dey of _.~IQJI_~~T~S$4 -----------, before nne peraonelly appeared ------------------------------------
Dora D. de Bened.etti~--------------------------------------------
-----------------------------------------------•---------------------------------- -
to me personelJy kno~vn, and lcnown to me to be ths individua!___ deacribed in, whoss
name _ ig__. eabacribed to, end who ezecuted ths ennezed inatruaeent, and bein~
informed by ms ot th~ contenta of aaid instrnmen! _.__ she__ duly acl~nowled~ed !o me
t~t She _ ezecuted ths aetme fr~ely and voluntarily for the ueea and putposes
therein montionsd.
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RGGER f'~~T~AS
CLERK CIRt~liT CG11R?
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Ta witneas ~vheteof I have hereunto ~et my hand end
officia/ aeal tha day and yesr las! above ivr ~ttan.
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Consul ~ eh. pn;e.a sr.e.. ot Aaar;o..
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No'~ -Where~er prscticabie all sianaturea to w doaumant should be induded in one oatiacata t
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