For Recorder’s Use Only

This only pertains to this document only

Please make certified copies in the amount
Of _____. The money order in the amount of
_____________________is inside of envelope
Thanks.

This certificate pertains to a certified copy of _________________________(title), consisting of

________ pages copied by ______________________________ (name of notary) on _____________
(date).

Copy Certification by Notary Public

State of Georgia

County of _________________

On this ___________________ , (Date)

I certify that this is a true, correct and complete copy made by me from the original record in the
possession of _______________________________________________________________

and that, to the best of my knowledge, the original record is neither a public record nor a publicly
recordable document, certified copies of which are available from an official source other than a notary
public.

_______________________________
(signature of notary public)
Notary Public, State of Georgia Stamp/Seal

My commission expires: ___________