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AFFIDAVIT OF EXECUTION
I, of the City of , Province of
MAKE OATH AND SAY THAT:
1. I was personally present and did see
named in the within (or annexed) instrument, who is personally known to me to
be the person named therein duly sign and execute the same for the purposes
named therein.
2. The same was executed at , in the Province of
and that I am the subscribing witness thereto.
3. I believe that the person(s) whose signature(s) I witnessed is/are of the full age