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E, , who, having been being first duty sworn by (Name of Affiant) the undersigned Notary Public, deposes and says: 1. He is the of (Title of Affiant) , (Name of Corporation) a corporation organized and existing under the laws of with (Name of State) its principal office located at , and in whose behalf (Street Address, City, County, State, Zip Code) he makes this affidavit. 2. . (Statement of facts) The above-mentioned corporation has caused this instrument to be executed in its behal.

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