>>> Resource: Notary Public of New York acknowledgement and proof of execution by a subscribing witness

Notary Public of New York

Proof of Execution by a Subscribing Witness

On the __________day of ______________________ in the year Two Thousand and ________________ (20_____) before me, the under-signed, personally appeared __________________________________________, the subscribing witness to the fore-going instrument, with whom I am personally acquainted, who, being by me duly sworn, did depose and say that he/she/they reside(s) in ______________________________________________________; that he/she/they know(s) ______________________________________________ to be the individual described in and who executed the foregoing instrument; that said subscribing witness was present and saw said _____________________________ execute the same; and that said witness at the same time subscribed his/her/their name(s) as a witness thereto.

Sworn before me

_________________________________________

Notary Public (print)

_________________________________________

Notary Public of New York State (seal)

{Notary Seal}

Registration no. #___________________________

Commission Expires:  ________________  ________,  20______.

Initials:  _______.  Date:      ____/____/ 20 ______.

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