Executed this _____ day of __________________, 20____ in _______________________.____________________.
| CERTIFICATE OF ACKNOWLEDGMENT JURAT |
COUNTY OF _____________________
Before me, ________________________________________________ on this day personally appeared _____________________________, known to me (or proved to me on the oath of ______________ or through ____________________________________________________________________ to be the person whose name is subscribed to the foregoing instrument and acknowledged to me that he executed the same for the purposes and consideration therein expressed. This instrument was acknowledged before me on _____________________, 20____, by ____________________________ as _______________________ of . Sworn to and subscribed before me on the ____________ dayof_____________, 20___, by _____________________________________.
| ________________________________________ |
| Notary Public in and for the State of Texas |
| My Commission expires: ______________ |