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Minnesota Public Facilities Authority <br />«BorrowerName» <br />By: <br />Title: <br />Dated: <br />By: <br />Title: <br />Dated: <br />STATE OF MINNESOTA ) <br />ss. <br />COUNTY OF ) <br />This forgoing instrument was acknowledged before me this _ day of , 20_, by <br />the [insert name and title of first signatory], and <br />the [insert name ant title of second signatory], <br />respectively, of the , a , [insert name and description <br />of the entity receiving the funds]. <br />Notary Public <br />This Declaration was drafted by: <br />[insert name and address] <br />GO Bond Special Appropriation Forms 25 of 32 August 2023 <br />