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OPTIONAI FORM 175
(FORMERLV FS-86)
MARCH 1975
OEPT. OF STATE
50175-301
Certificate of Acknowledgment of Execution of an Instrument
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JA-AN (C'ountry) ~"
CR1/ OR TOICrO ~M
tY~/IfSY OF TM[ UNITiD fTATp OF AM[~/C~A )
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(CouMy and(or othrr p..litical dnision)
.tiS:
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(County and/ot oth~r pulrtical divis~un)
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(Name of fore~gn sen•ice office)
Jar~es F. Cole _~ice Consul
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o~'the United S~vtes ~~jAnieric~a ut~_______________________ Tokyo,_ Janan,_
Julv com-nissinn~J ai~~l quuli~r`e~J. d~~ /lere~h-~ certif i~ thu! un N~is 26tr
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day of--- ~Iovember, 1990 hejore »~e pr~s~»ra!!-' u~~~~cure•d ---------
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rvaTt•~ -----
~ ~ A •• ~~ Jerome E. 'AEINSTOCK ~• •~ •• •• ••
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[o me per.sonully k~roti~~i:. u~tcl knni~~n tu i-~e to be Nie iirdiriduul--vescribe~cl in. x~hose
nwne__ls __suhscribed t~~. und u~ho e.recuted thc• an~re_red iitstru-~~en1. a~id being
injormed hy me ojthe co~rtents njsuid i~rs~rr~n~e~rt~he ___diJ}~ ucl~n~~-vlec/gcd to nre
i
~
that he exectited tlre same~~jreelti~ u~rJ rolr~nturily jor the r~ses und puiposes therein s
1981 JAN -8 A!~ 9~ 03
. FiifO ~Nf ~ECGNi': i'
5~ ~6•5g S ROG R PC TRASa.
CIERK Ct~ ~ti:7 ~GL~~~
=c f.f:" • . ~ -
/~~ ~ti~ihress -vlrerrojl fture Iteret~itlo sel my ltand aird
~,jl«~r,
written.
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~anes F. Cole
V ice Consul __ ~ f the United States oj America
--- 8001~f ~~ PAGE ~c32
ill s~nawres tu a dorument ~hould be included in une cerUftcate.