The foregoing instrument was acknowledged before me this ______ day of 20____, by
(name of attorney in fact) as attorney in fact, who is personally known to me or who has
produced (type of identification) as identification on behalf of (name of principal signer.)
____________________________
(Seal) Signature of Notary Public
Print, Type/Stamp Name of Notary
Personally known:_________
OR Produced Identification:__________
Type of Identification Produced:________
For a corporation:
STATE OF FLORIDA
COUNTY OF __________
The foregoing instrument was acknowledged before me this ______ day of 20____, by
(name of officer or agent, title of officer or agent) of (name of corporation
acknowledging, a (state or place of incorporation) corporation, on behalf of the
corporation.
____________________________
(Seal) Signature of Notary Public
Print, Type/Stamp Name of Notary
Personally known:_________
OR Produced Identification:__________
Type of Identification Produced:________
For a partnership:
STATE OF FLORIDA
COUNTY OF __________
The foregoing instrument was acknowledged before me this ______ day of 20____, by
(name of acknowledging partner or agent) partner (or agent), on behalf of (name of
partnership), a partnership.
____________________________
(Seal) Signature of Notary Public
Print, Type/Stamp Name of Notary
Personally known:_________
OR Produced Identification:__________
Type of Identification Produced:________