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STATE OF MINNESOTA <br />COUNTY OF HENNEPIN <br />On this_ day of ____ , 2002, __________ personally appeared <br />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 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 6