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By:
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[ John-Alex: Doe-El ], Sui Juris
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WITNESSES
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We the undersigned Witnesses hereby stand and attest that the fore-signed, signed this document on the date
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______________________________________ __________________________________
By: Jones - Anthony, Smith By: Jackson - Andrew, Smith
c/o 123 Any St. Anytown, California c/o 123 Any St. Anytown, California