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IN WITNESS WHEREOF,the undersigned has executed this instrument the day and year first set <br /> forth. <br /> DECLARANT: <br /> (signature) <br /> By:'I - (print name) <br /> (title) of <br /> (company o1 <br /> or anization) <br /> State of_►-'� rA rte so \, <br /> County of 0*AA ►P+ r-� <br /> This instrument was acknowledged before me on:SC\n�cgl I,?L+`�date) by <br /> (name(s) ofperson(s))as T,, , j , C.) ( k . (type of <br /> b' g ff C' t` (name <br /> authority, e. ., o rcer, trustee, etc.) �;, -�,�� ,'� - <br /> ofparry on hehal f of ivhom the ipso ument was ex�rrted). <br /> � (Signature of notarial officer) <br /> ---------- <br /> (Stamp) <br /> (Stamp) 'heresa Ann Zerby <br /> No"Puft <br /> Title(and Rank) �d t /2018 <br /> My commission expires: <br /> This Instrument Was Drafted By: <br /> [INSERT NAME AND ADDRESS OF WHOEVER FILLED OUT THE TEMPLATE <br /> OA�j � / <br />