State of Nevada
County of............................................
This instrument was acknowledged before me on .......(date)....... by .......(name(s) of person(s))....... as .......(type of authority, e.g., officer, trustee, etc.)....... of .......(name of party on behalf of whom instrument was executed)........
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(Signature of notarial officer)
(Seal, if any)
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(Title and rank (optional))
(Added to NRS by 1993, 203; A 1995, 196; 2001, 656; 2003, 611)