The following short form certificates of notarial acts are sufficient for the purposes indicated, if completed with the information required by subsection A of Section 8 of this act:

1. 1. 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 notarial officer) (Seal, if any) _________________________________
   Title (and Rank)
   (My commission expires: )

2. 2. 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 notarial officer)
   (Seal, if any) __________________________________
   Title (and Rank)
   (My commission expires: )

3. 3. For a verification upon oath or affirmation:

   State of
   County of Signed and sworn to (or affirmed) before me on (date) by (name(s) of person(s) making statement). __________________________________
   (Signature of notarial officer) (Seal, if any) __________________________________
   Title (and Rank)
   (My commission expires: )

4. 4. 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 notarial officer) (Seal, if any) __________________________________
   Title (and Rank)
   (My commission expires: )

5. 5. For attestation of a copy of a document:

   State of
   County of

   I certify that this is a true and correct copy of a document in the possession of

   Dated __________________________________
   (Signature of notarial officer) (Seal, if any) __________________________________
   Title (and Rank)
   (My commission expires: )

Laws 1985, HB 1229, c. 131, § 9, eff. November 1, 1985.