(a) The following short form certificates of notarial acts are sufficient for the purposes indicated, if completed with the information required by W.S. 32-3-114:

(i) For an acknowledgment in an individual capacity:

State of _______

County of _______

This record was acknowledged before me on (date) by (name(s) of person(s)).

(Stamp) (Signature of notarial officer)

Title (and Rank)

[My commission expires: ]

(ii) For an acknowledgment in an representative capacity:

State of _______

County of _______

This record 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).

(Stamp) (Signature of notarial officer)

Title (and Rank)

[My commission expires: ]

(iii) For a verification on 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)

(Stamp) (Signature of notarial officer)

Title (and Rank)

[My commission expires: ]

(iv) For witnessing or attesting a signature:

State of _______

County of _______

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

(Stamp) (Signature of notarial officer)

Title (and Rank)

[My commission expires: ]

(v) For certifying a copy of a record:

State of _______

County of _______

I certify that this is a true and correct copy of a record in the possession of _______.

Dated_______

(Stamp) (Signature of notarial officer)

Title (and Rank)

[My commission expires: ]