ACKNOWLEDGEMENT and JURAT

REPUBLIC OF THE STATE of TEXAS)

County of
_____________________________) S.S.

BEFORE ME, a Notary Public for and in the above jurisdiction, this _____ day of
_________________,2018, personally appeared:

Name CTC No. Date/Place Issued

Known to me and by me known to be the same person who executed the foregoing Instrument
Government Obligations Remittance Coupon Consisting Of two pages including this page where this
acknowledgement and Jurat Is Written and acknowledged To Me That the same is his/her Own Free
and voluntary act and deed as the original signer of the instrument.
Witness my hand and notarial seal on the date and at the place first above written.

Doc. No._______
Page No._______
Book No._______
Series of _______