Acknowledgment for Individual

CONNECTICUT ACKNOWLEDGMENTS

State of Connecticut

County of __________________

On this the ____________ day of _____________________, ____________, before me, ________________________ (name of notary), personally appeared ____________________________________, known to me (or satisfactorily proven) to be the person(s) whose name(s) _________ ( is or are) subscribed to the within instrument and acknowledged that ________________________ (he/she/they) executed the same for the purposes therein contained.

In witness whereof I hereunto set my hand.

Date:___________________________

_________________________________

Notary Public

Print Name: _______________________

My Commission Expires:

____________________

Acknowledgment for Corporation

State of Connecticut

County of ________________________

On this the ______________ day of ______________, ______________, before me, a Notary Public, personally appeared __________________________________________ (Name of Officer) who acknowledged himself/herself to be the ________________________ (Title of Officer) of ____________________________ (Name of Corporation), a corporation, and that he/she, as such ____________________________ (Title of Officer), being authorized so to do, executed the foregoing instrument for the purposes therein contained, by signing the name of the corporation by himself/herself as ____________________________ (Title of Officer).

In witness whereof I hereunto set my hand.

Date:___________________________

_________________________________

Notary Public

Print Name: _______________________

My Commission Expires:

_____________________

BY ATTORNEY IN FACT

State of Connecticut

County of ________________________ (Town/City)

On this the __________ day of __________, 20___, before me, __________________, the undersigned officer, personally appeared ____________________, known to me (or satisfactorily proven) to be the person whose name is subscribed as attorney in fact for ____________________, and acknowledged that he executed the same as the act of his

principal for the purposes therein contained.

In witness whereof I hereunto set my hand.

Date:___________________________

_____________________________

(Signature of Notary Public)

My Commission Expires:

______________________

BY ANY PUBLIC OFFICER OR DEPUTY, TRUSTEE, ADMINISTRATOR, GUARDIAN OR EXECUTOR

State of Connecticut

County of ________________________ (Town/City)

On this the _____ day of _______________, 20___, before me, ___________________, the undersigned officer, personally appeared ______________________________, of the State (County or City as the case may be) of _______________, known to me (or satisfactorily proven) to be the person described in the foregoing instrument, and acknowledged that he executed the same in the capacity therein stated and for the purposes therein contained.

In witness whereof I hereunto set my hand.

Date:___________________________

_____________________________

(Signature of Notary Public)

My Commission Expires:

______________________

REFERENCE:

*Sections 1-28 through 1-41 cited. 176 C. 17, 23.

Connecticut

Conn. Gen. Stat. § 1-28 (1999) Permissible Forms of Acknowledgement

http://www.cslnet.ctstateu.edu/statutes/title1/t1-p7.htm - I3

Conn. Gen. Stat. § 1-29 (1999) Acknowledgements Within State