Free notary acknowledgement 40
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This certificate is attached to a

page document dealing with/entitled

and dated

Acknowledgment in an Individual Capacity

State of Georgia
County of
This record was acknowledged before me on
Date

by

,
Printed name(s) of individual(s) signing document

who proved to me on the basis of satisfactory evidence to be the person(s)
who appeared before me.
Personally Known
or
Produced Identification
Type ID

Signature of notary public

(Name of notary, typed, stamped or printed)

Notary Public State of Georgia
My commission expires:

Acknowledgment Ver C

Stamp/Seal

.