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SAMPLE FORM

ACKNOWLEDGEMENT OF CORPORATION

STATE OF               Kansas¹     )
                                                       )ss
COUNTY OF           Johnson²     )

The foregoing instrument was acknowledged before me this 21st day of

April , 2001³, by Ray Dane, President⁴

(name of officer or agent, title of officer or agent) of MIN Corp.⁵

(name of corporation acknowledging) a Kansas⁶ (state or place

of incorporation) corporation, on behalf of the corporation.

_______________________⁷ Signature

Notary Public⁸
Title

NOTES
The above is an example of how a typical Acknowledgement for Corporation form may be completed.

The state in which the document is acknowledged.
The county in which the document is acknowledged.
The date the document is signed.
The full name and title of the representative of the corporation.
The full name of the corporation.
The sate in which the corporation is located.
The signature of the person notarizing the document.
The title of the person notarizing the document.

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This is not a substitute for legal advice. An attorney must be consulted.