State of __________________________________________
County of _________________________________________
This record was acknowledged before me on (date) by (name(s) of person(s)).
(Stamp) (Signature of notarial officer)
Title (and Rank)
[My commission expires: ]
State of __________________________________________
County of _________________________________________
This record was acknowledged before me on (date) by (name(s) of person(s)) as (type of authority, e.g., officer, trustee, etc.) of (name of party on behalf of whom instrument was executed).
(Stamp) (Signature of notarial officer)
Title (and Rank)
[My commission expires: ]
State of __________________________________________
County of _________________________________________
Signed and sworn to (or affirmed) before me on (date) by (name(s) of person(s) making statement)
(Stamp) (Signature of notarial officer)
Title (and Rank)
[My commission expires: ]
State of __________________________________________
County of _________________________________________
Signed or attested before me on (date) by (name(s) of person(s)).
(Stamp) (Signature of notarial officer)
Title (and Rank)
[My commission expires: ]
State of __________________________________________
County of _________________________________________
I certify that this is a true and correct copy of a record in the possession of.
Dated___________________
(Stamp) (Signature of notarial officer)
Title (and Rank)
[My commission expires: ]
W.S. 32-3-115