WPCN  BgRuy&vڠi ^q\G,6BFE  ________________________,thesubscribingwitnesstotheforegoinginstrument,withwhomI + { ampersonallyacquainted,who,beingbymedulysworn,diddeposeandsaythathe/she/they  h reside(s)in______________________(iftheplaceofresidenceisinacity,includethestreet  U  andstreetnumber,ifany,thereof);thathe/she/theyknow(s)________________________tobe  B  theindividualdescribedinandwhoexecutedtheforegoinginstrument;thatsaidsubscribing /  witnesswaspresentandsawsaid________________________executethesame;andthatsaid   witnessatthesametimesubscribedhis/her/theirname(s)asawitnessthereto.   _____________________________  SignatureandOfficeofindividual m takingproof Z