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Heir
Heir
Heir
Heir
Heir
____________________________
THE )
S.S.
)
X-------------------------------x
BEFORE ME, a Notary Public in and for the City of __________, this ___
day of _______________ 2016, personally appeared the following persons who
exhibited to me their corresponding government-issued identification cards,
to wit:
NAME
GOVERNMENT-ISSUED
I.D.
I.D. NUMBER/DATE
ISSUED
_____
_____
_____
2016