I'm an asss.

How do I fill this out?

On this "16th" day of "March 2009", before me personally appeared "so and so" to me known to be the person named in and who executed the above release and acknowledged that "blank (does HE or SHE go here?)" executed the same as "blank (I have no idea what goes here - HIS or HERS?)" own free act and deed.


Thanks!!