Printed/Typed Name Printed/typed name Instructions Notarization Language for Duly Authorized Agent for Grantee (Licensed Environmental Professional): State of County of On this day of before me, Day Month, Year Name of Notary Public or Commissioner of the Superior Court the undersigned officer, personally appeared known to me (or Name of Individual or Individuals, satisfactorily proven) to be the person(s) whose name(s) subscribed to the within instrument and is/are acknowledged that executed the same for the purposes therein contained. he/she/they In witness whereof I hereunto set my hand. Notary Public or Commissioner of the Superior Court Date Commission Expires Date
Printed/Typed Name Printed/typed name Instructions Notarization Language for Duly Authorized Agent for Grantee (Licensed Environmental Professional): State of County of On this Day day of Month, Year before me, Name of Notary Public or Commissioner of the Superior Court the undersigned officer, personally appeared Name of Individual or Individuals, known to me (or satisfactorily proven) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged that he/she/they executed the same for the purposes therein contained. In witness whereof I hereunto set my hand. Notary Public or Commissioner of the Superior Court Date Commission Expires Date
elur_application.docx