The following short form certificates of notarial acts are sufficient for the purposes indicated.

1. (a) For an acknowledgment in an individual capacity:

   State of _________________

   County of ________________

   This instrument was acknowledged before me on ___________(date) by ___________________(name/s of person/s).

   ____________________________ (Signature of Notary Public) (Seal)

2. (b) For an acknowledgment in a representative capacity:

   State of ______________________

   County of _____________________

   This instrument was acknowledged before me on _________(date) by __________________(name/s of person/s) as _________________________________(type of authority, e.g., officer, trustee, etc.) of _________________________(name of party on behalf of whom instrument was executed).

   _______________________________ (Signature of Notary Public) (Seal)

3. (c) For a verification upon oath or affirmation:

   State of _________________

   County of_________________

   Signed and sworn (or affirmed) to before me on _________(date) by _____________________(name/s of person/s making statement).

   _______________________________ (Signature of Notary Public) (Seal)

4. (d) For witnessing or attesting a signature:

   State of_________________

   County of _______________

   Signed or attested before me on __________(date) by __________________(name/s of person/s).

   _______________________________ (Signature of Notary Public) (Seal)

(from Ch. 102, par. 206-105)

(Source: P.A. 84-322.)