AB985,,37737712. The name, state bar number, and [business or residential] address of the supervising attorney is ....
AB985,,37837813. [Optional] Other information that the supervising attorney considers to be material is as follows: ....
AB985,,379379.... (signature of supervising attorney)
AB985,,380380Subscribed and sworn to before me on .... (date) by .... (name of supervising attorney).
AB985,,381381.... (signature of notarial officer)
AB985,,382382Stamp
AB985,,383383.... (Title of office)
AB985,,384384[My commission expires: ....]
AB985,,385385(end)