I, [YOUR NAME], a duly commissioned and sworn notary public, within and for the state of [YOUR STATE], do hereby certify that on this day of [DATE], at my said office, personally came before me [CLIENT'S NAME], satisfactorily proved to me to be the person named in and who executed the foregoing instrument.

I. Verification of Identity

The identity of said [CLIENT'S NAME] was verified by me to be true and correct to the best of my knowledge. The identification provided was as follows:

• Type of Identification: [TYPE OF IDENTIFICATION USED]

• Identification Number: [ID NUMBER]

• Issued by: [ISSUING BODY]

• Date of Issue: [DATE OF ISSUE]

• Date of Expiration: [DATE OF EXPIRATION]

II. Acknowledgement of Freewill

Said [CLIENT'S NAME] acknowledged to me, that he/she executed the instrument freely and voluntarily for the purposes therein set forth. My commission expires [DATE OF COMMISSION EXPIRATION].

III. Stamp and Signature

As a Notary Public, I hereby affix my official seal and signature below:

[NOTARY PUBLIC SIGNATURE DRAG AND DROP FIELD]

[NOTARY PUBLIC SEAL STAMP DRAG AND DROP FIELD]

IV. Notarial Certification

Given under my hand and notarial seal this [DAY] day of [MONTH], [YEAR].

[YOUR NAME]
Notary Public for the State of [YOUR STATE]
My Commission Expires: [DATE OF COMMISSION EXPIRATION]

Notary Templates @ Template.net