State of California             }ss.

   County of  }
      On (date), before me, the undersigned, a notary public for the state, personally appeared 
  (name of subscribing witness). proved to me to be the person whose name is subscribed to the     within  instrument. as a witness thereto. on the oath of (name of credible witness). a credible witness   who is known to me and provided a satisfactory identifying document. (name of subsribing witness).   being by me duly sworn. said that he/she was present and saw/heard  (names[s] of principal[s]). the   same person(s) described in and whose name(s) is/are subscribed to the within or attached instrument in.   his/her/their authorized capacity(ies) as (a) party(ies) thereto. execute or attached instrument as a witness at the   request of (name[s] of principal[s]).
  WITNESS my hand and official seal.

Signature ______________________________ (Notary public seal)