the city of ____________.
The _________ day of _____________, two thousand and ____________.
This statement was certified by me, ________ __________ _________, Notary of the city of ___________.
The content of this statement is in line with the intention of the person who appeared before me, whose identity has been determined, and legal capacity has been proven.
The statement was signed before me.
The identity of the signatory has been determined, his legal capacity has been proven.
Registered in the Register under No. _-____
State fee charged as per tariff: 500 roubles. 00 kopecks
Charged for legal and technical services: 2,000 roubles, 00 kopecks
[Seal: Notary of the city of _____________, _______________]
[Russian Federation, the city of _________, 11. 11. 2011, I, _______________________________, Notary of the city of Moscow, hereby certify that the copy made from the original statement submitted to me and registered in the register under No. _-____ is true. State fee charged as per tariff: 20 roubles, fee charged for legal and technical services: 100 roubles, _______________]
[Seal: Notary of the city of ____________, ____________]
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