Affidavit of Mailing of Notice of Annual Meeting : Please fill out the following form. Please print your completed form if you would to have a copy for your records.




STATE OF


COUNTY OF


I (Name of the person) being duly sworn accordingly by law, do hereby depose and say:


I am the Secretary of (Name of the company) and that on the (DATE). I personallydeposited copies of the aforesaid notice of annual meeting in a post-office box in the City of (CITY) State of (STATE) prepaid postage.


Each copy of the notice was in a securely sealed and stamped envelope. One copy wasaddressed to each person whose name appears on the attached list and to respective addresses asshown on the list.


Secretary :


On _________________ before me ________________ personally appeared ________________________ personally known to me (orproved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.


WITNESS my hand and official seal.


Signature :


Affiant : Known / Unknown


ID Produced :


Seal :





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