Acknowledgment of a Mark
His Mark
Signature / Mark (First name X Last
Name)
Witness:
Witness Signature
Witness Signature
Witness Print Name
Witness Print Name
Witness Address
Witness Address
State of Texas
County of ___________
Before me, Charles Jackson, Notary Public, on this day personally
appeared____________________________, known to me (or proved to me
on the oath of ______________ or through _____________ (description of
identity card or other document) to be the person whose mark is made on
the foregoing instrument and acknowledged to me that he executed the
same for the purposes and consideration therein expressed.
Given under my hand and seal of office this ______ day of ________,
20___.
____________________
Notary Public Signature
(seal)