Section 200.APPENDIX A   Franchise Registration Forms

Section 200.ILLUSTRATION M   Joint Venture Agreement & Acknowledgment

On this        day of ,                                 , before me the undersigned officer, personally appeared                  and                  to me known personally to be the authorized representative(s) of                 , a joint venture undertaking, whose name(s) is signed to the foregoing instrument, and that he (they), as such representative(s), being authorized to do so, executed the foregoing instrument for the purposes therein contained, by signing the name of the joint venture by himself (themselves) as such authorized representative(s).

IN WITNESS WHEREOF I have hereunto set my hand and official seal.

(Source:  Amended at 23 Ill. Reg. 11561, effective September 7, 1999)