The undersigned hereby certifies that he/she was engaged in the _____________________________________________

business under the name of _______________________________________________________________ and that on

this date ___________________________________he/she has withdrawn from such enterprise.

_____________________________________________________________________________________________

Name

____________________________________

Address

________________________________________

Signature

Personally appeared before me the above signed ________________________________________________________

and made oath to the truth of the above certification on this __________ day of _________________________________

_______________________, 20 _____.

__________________________________________

Notary Public