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Cer

ti
fi
cat
eofResi
dency

Dat
e:_
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I
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__,oflegalage,withpost
aladdressand
r
esidentaddressat____
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, do her eby cer t
if
ies t hat
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___,is presentlyr esi
ding at the address
mentionedabove.

Donef
orwhat
everl
egal
pur
posei
tmayser
ve.

Si
ncer
elyy
our
s,

Si
gnat
ureov
erpr
int
edname

conf
orme:

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Pur
chaser

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