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Signed, sealed and delivered <br /> In the presence of: <br /> By: <br /> Witness <br /> Witness (Print Name) <br /> (Title) <br /> ACKNOWLEDGEMENT <br /> STATE OF <br /> SS: <br /> COUNTY OF <br /> BEFORE ME, the undersigned authority, personally appeared <br /> to me well known and known by me to be the person described <br /> herein and who executed the foregoing Affidavit and acknowledged to and before me that <br /> executed said Affidavit for the purpose therein <br /> expressed. <br /> WITNESS, my hand and official seal this day of , 20_ <br /> By: <br /> (Title) <br /> NOTARY PUBLIC <br /> State of Florida-at-Large <br /> My Commission Expires: <br /> 00300-22/26 <br />