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I, [name and style of officer], hereby certify that.

whose name is signed to the foregoing conveyance, and who is known to me, acknowledged before me on this day, that being informed of the contents of the conveyance, he executed the same voluntarily on the day the same bears date.

Given under my hand this . . . day of . . [L. S.]

.

A. D. 19

[Official title]

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I, [name and style of officer], do hereby certify that on the ... day of

within named

A. D. 19

came before me the known to me [or, made

known to me] to be the wife of the within named

who being examined separate and apart from

her husband, touching her signature to the within

acknowledged that she signed the same of her own free will and accord, and without fear, constraints, or threats on the part of the husband.

In witness whereof, I have hereunto set my hand this . . day of . . ..

A. D. 19

[L. S.]

[Official title]

For notice of copyright, see page immediately following the title page

State of.

County of

ACKNOWLEDGMENT FOR CORPORATION

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SS.

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I, [name and style of officer] in and for said state and county, hereby certify that . . . as president of [name of corporation], whose name is signed to the foregoing conveyance and who is known to me to be the president of said [name of corporation], acknowledged before me on this day that being informed of the contents of the above conveyance, he executed the same voluntarily as the act and deed of said [name of corporation] on the day the same bears date, and that he is duly authorized by said corporation to execute this conveyance.

Given under my hand this . . . day of

A. D.

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I, [name and style of officer], hereby certify that . . ., a subscribing witness to the foregoing conveyance, known to me, appeared before me this day, and being sworn, stated that. . ., the grantor in the conveyance, voluntarily executed the same in his presence, and in the presence of the other subscribing witness, on the day the same bears date; that he attested the same in the presence of the grantor and of the other witness, and that such other witness subscribed his name as a witness in his presence.

19

Given under my hand this . . . day of

A. D.

[L. S.]

[Official title]

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Before me, [name and character of the officer], on this day personally appeared

known to me [or, ..] to be the

proved to me on the oath of . . person whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed the same for the purpose and consideration therein expressed.

Given under my hand and seal of office this. . . day of A. D. 19

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Before me, [name and character of the

day personally appeared. .

officer], on this

wife of . . .

known to me [or, proved to me on oath of .] to be the person whose name is subscribed to the foregoing instrument, and having been examined by me privily and apart from her husband, and having the same fully explained to her, she, the said . . .

acknowledged such instrument to be her act and deed, and declared that she had willingly signed the same for the purposes and consideration therein expressed, and she did not wish to retract it.

Given under my hand and seal of office this. . . day of A. D. 19

[L. S.]

[Official title]

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