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STATE OF MINNESOTA <br />COUNTY OF HENNEPIN <br />On this __ day of ____ .,2003, _______________ personally <br />appeared before me, <br />__ who is personally known to me <br />__ whose identity I proved on the basis of ________________ _ <br />__ whose identity I proved on the oath/affirmation of ____________ , a <br />credible witness <br />and who executed the foregoing instrument, and aclmowledged that he/she/they executed the same as <br />his/her/their free act and deed. <br />STATE OF MINNESOTA <br />COUNTY OF HENNEPIN <br />Notary Public <br />On this_ day of ____ , 2003, _______________ personally <br />appeared before me, <br />__ who is personally lmown to me <br />__ whose identity I proved on the basis of _________________ _ <br />__ whose identity I proved on the oath/affirmation of ____________ , a <br />credible witness <br />and who executed the foregoing instrument, and acknowledged that he/she/they executed the same as <br />his/her/their free act and deed. <br />Notary Public <br />Page 5 of 5