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pf_03161
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pf_03161
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7/17/2007 12:50:02 PM
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12/8/2004 3:56:54 PM
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<br />INSTRUCTIONS: <br /> <br />1. This side is to be completed by a notary public for both the Principal and the Surety. <br />2. Please attach the Power of Attorney and Certified Copy of the Corporate Resolution for the Surety listed herein. <br /> <br />ACKNOWLEDGMENT OF INDIVIDUAL <br /> <br />) <br />) ss. <br />) <br /> <br />ACKNOWLEDGMENT OF PRINCIPAL <br /> <br />STATE OF <br />COUNTY OF <br /> <br />On this day of . 199_, before me personally appeared <br />known to me as the individual whose name is subscribed on this bond <br />form, who acknowledged that this bond was executed for the purposes therein contained. <br /> <br />Notary Public <br /> <br />[Notary Sea~ <br />. * . . . . . . . * * * . . * * . * * * . . . . . * * . . . . * . . . . . . . . . * . . * * . . * . . * . * . . . . . * . <br /> <br />ACKNOWLEDGMENT OF PARTNERSHIP <br /> <br />STATE OF <br /> <br />COUNTY OF <br /> <br />) <br />) ss. <br />) <br /> <br />ACKNOWLEDGMENT OF PRINCIPAL <br /> <br />On this day of .199_, before me personally appeared <br />known to me to be a partner in the partnership whose name is <br />subscribed on this bond form, who acknowledged to me that this bond was executed on behalf of the partnership for the purposes <br />therein contained. <br /> <br />Notary Public <br /> <br />[Notary Sea~ <br /> <br />* . . . . * . . . * . . . . * * * * * * * . * . . . * * . . . * . . . . . * * * . * * . . * * . . . * . . . . . * * * . <br /> <br />ACKNOWLEDGMENT OF CORPORATION <br /> <br />STATE OF /Jl/V DG 50 T ,4- <br />COUNTY OF ,DAleo r A <br /> <br />) <br />) ss. <br />) <br /> <br />On this ~ 3a. day of A c.J G-IJ .<; r , 199~, before me personally appeared <br />~~ ~:JJ~ ~ IJ who acknowledged that he or she is the <br />po A- IfE'If!!6t a corporation whose name is subscri on this bond form, and that, as a corporate officer, he or <br />she is authorize~ oses therein contain . <br />Ie JANET K. NICHOLS <br />. ~ NOTARY PUBLIC - r,;iNNESOTA <br />. HENNEPIN COUNTY <br />My Comm. Expires Jan. 31, 2000 <br />[Notary Seal] .W"N#N';'-~~. <br /> <br />ACKNOWLEDGMENT OF PRINCIPAL <br /> <br /> <br />* . . . . . . . * * * . * * . * * . * . . * . . . . . . * . * * * . . . . . . * . . . . . . . . * * * * * . . * . . . . . <br /> <br />ACKNOWLEDGMENT OF SURETY <br /> <br />STATE OF <br /> <br />COUNTY OF <br /> <br />) <br />) ss, <br />) <br /> <br />ACKNOWLEDGMENT OF SURETY <br /> <br />On this <br /> <br />day of <br /> <br />.199_, before me personally appeared <br />who acknowledged that he or she is the attomey in fact who is <br />(surety company), <br /> <br />authorized to sign on behalf of <br /> <br />, corporation, on behalf of the corporation. <br /> <br />(state or place of corporation) <br /> <br />Notary Public <br /> <br />[Notary Sea~ <br />
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