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Affirmed) before me on this day of , 20 , by , Subscribed and the basis of affirmed) before me on be proved to me on sworn to (or satisfactory evidence tothis the day of , 20 , by person(s) who appeared before me. , (Seal) Signature proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. (Seal) Sign.
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