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AFFIDAVIT OF EXECUTION FOR WITNESS

I,                           ,

of                           , in the province of                           ,

MAKE OATH AND SAY:

1.   I was personally present and did see         (name of maker) sign the attached document.

2.   The document was signed at                     ,

in the province of                     , and that I am the subscribing witness thereto.

3.   That I know the maker of the document, and he or she is in my belief of the full age of majority.

SWORN BEFORE ME,                           (print name of notary/commissioner),

at                          , in the province of                           , on

_____________________________, 20                          .

(Signature of notary public/commissioner of oaths)