Certificate of Incumbency

CERTIFICATE OF INCUMBENCY

I, [Full Name of Business Owner/Secretary etc.], being the [Job Title] of [Name of Company] (the "Corporation"), a corporation incorporated under the laws of the State of [Name of State], do hereby certify as follows:

1. That I am the duly elected and qualified [Job Title] of the Corporation.
2. That pursuant to the Corporation's By-Laws, I have the power and authority to execute this certificate on behalf of the Corporation.
3. That from my examination of the minute book and other pertinent records of the Corporation in my possession, and of my own knowledge, the following individuals were designated and appointed to the offices listed below and hold these offices at the time of signing.
4. That the signatures opposite the names below are genuine signatures.

NAME                    TITLE           SIGNATURE
[Full Name 1]        [Title 1]        [Underlined Space for Signature 1]
[Full Name 2]        [Title 2]        [Underlined Space for Signature 2]
[Add as many officer names, titles, and signatures as required.]

I also certify that the appointed Officer(s), by virtue of the authority delegated by the Board of Directors of the Corporation, is/are authorized to act on behalf of the Corporation by [List of Duties Officers Can Perform].

I also certify that the undersigned are the Directors of the Corporation and that the signatures opposite their names are genuine signatures.

NAME                   SIGNATURE
[Full Name 1]        [Underlined Space for Signature 1]
[Full Name 2]        [Underlined Space for Signature 2]
[Add as many director names and signatures as required.]

I also certify that the undersigned are the Shareholders of the Corporation and that the signatures opposite their names are genuine signatures.

NAME                   SHARES HELD
[Full Name 1]        [Number and Type of Shares 1]
[Full Name 2]        [Number and Type of Shares 2]
[Add as many shareholder names and numbers and types of shares as required.]

IN WITNESS WHEREOF, I have hereunto subscribed my name and posted the seal of the Corporation on this [Underlined Space for Day Number] day of [Underlined Space for Month], [Underlined Space for Year].

[Underlined Space for Signature of Business Owner/Secretary etc.]
[Full name of Business Owner/Secretary etc.]
[Job Title]
[Space for Company Seal]

The appointments detailed expire [Period of Validity] from the date above. This form must be accompanied by supporting documents.