Release of Power of Appointment
ACKNOWLEDGEMENTS
Acknowledgement taken in New York State
STATE OF NEW YORK
COUNTY OF , ss:
On the day of , in the year 20 , before me the undersigned, personally appeared personally
known to me or proved to me on the basis of satisfactory evidence, to be the individual(s) whose name(s) is (are) subscribed
to the within instrument and acknowledged to me that (he) (she) (they) executed the same in (his) (her) (their) capacity(y)
(ies), and that by (his) (her) (their) signature(s) on the instrument, the individual(s) or the person upon behalf of which the
individual(s) acted, executed the instrument.
_______________________________
Notary Public
Acknowledgement taken outside New York State
*STATE OF
COUNTY OF , ss:
* (or insert District of Columbia, Territory, Possession or Foreign Country)
On the day of , in the year 20 , before me the undersigned, personally appeared personally
known to me or proved to me on the basis of satisfactory evidence, to be the individual(s) whose name(s) is (are) subscribed
to the within instrument and acknowledged to me that (he) (she) (they) executed the same in (his) (her) (their) capacity(y)
(ies), and that by (his) (her) (their) signature(s) on the instrument, the individual(s) or the person upon behalf of which the
individual(s) acted, executed the instrument, and that such individual(s) made such appearance before the undersigned in the
(add the city or political subdivision and the state or country or other place the acknowledgment was taken).
_______________________________
Notary Public
Acknowledgement by Subscribing Witness taken in New York State
STATE OF NEW YORK
COUNTY OF , ss:
On the day of , in the year 20 , before me the undersigned, personally appeared the
subscribing witness to the foregoing instrument, with whom I am personally acquainted, who being by me duly sworn, did
depose and say, that (he) (she) (they) reside(s) in ; that (he) (she) (they) know(s) to be the individual described
in and who executed the foregoing instrument; that said subscribing witness was present and saw said execute the
same; and that said witness at the same time subscribed (his) (her) (their) name(s) as a witness thereto.
_______________________________
Notary Public
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