CERTIFICATION OF MAILING

 State of ________________       )                                             

                                                 )  ss.      

County of _______________     )

On this _________day of ____________, 20______, for the purpose of verification, I, the undersigned Notary Public, being commissioned in the County and State noted above, do certify that John Lee Doe appeared before me with the following documents listed below.  I, the below signed notary, personally verified that these documents were placed in an envelope and sealed by me. They were sent by United States Post Office Registered Mail receipt number REGISTERED MAIL# to NAME&ADDRESS OF THE RECEIVER.

LIST OF DOCUMENTS MAILED

(List all documents that are enclosed in your envelope in the order they are placed in the envelope.)

 WITNESS my hand and official seal.

________________________________________________          ________________                             NOTARY SEAL

NOTARY PUBLIC                                                                  DATE

My commission expires:  _________________________, 20_______