Short Form Notary Certificate

I. Purpose

This certificate, which is a short form notary, has been specifically designed to be used when you are sending notarized documents to different establishments. These include government departments or agencies, educational institutions like schools, colleges, or universities, or even your present or future employers. Its primary purpose is to provide an appropriate format when supplying these notarized documents to these mentioned establishments.

II. Notary Details

Notary Public Name: [Your Name]
Notary Public Commission Number: [Commission Number]
State of Commission: [State]
County of Commission: [County]
Date of Notarization: [Date]

III. Document Details

Document Title: [Document Title]
Signer's Name: [Signer's Name]
Date of Document: [Document Date]

IV. Notarial Act

This is to certify that on the above-mentioned date, before me, [Your Name], a Notary Public in and for the State of [State], personally appeared [Signer's Name], known to me (or proved to me based on satisfactory evidence) to be the person whose name is subscribed to the foregoing document, and acknowledged to me that they executed the same for the purposes therein contained.

V. Witnessed Signatures

[SIGNER'S NAME]

[DATE SIGNED]

[YOUR NAME], Notary Public

[NOTARY SEAL]

I certify under PENALTY OF PERJURY under the laws of the State of [State] that the foregoing paragraph is true and correct.

Executed on: [Date]