NOTARY CERTIFICATE FORM

Please fill out this Notary Certificate Form, completed by [YOUR NAME], detailing the notarization of a specific document or transaction.

• [DATE OF NOTARIZATION]

• [DOCUMENT OR TRANSACTION TYPE]

• [ID TYPE USED FOR VERIFICATION]

• [SIGNATORIES' NAMES]

I. VERIFICATION OF IDENTITY

I, [YOUR NAME], a commissioned Notary Public for the State, do verify that [SIGNATORY 1 NAME], and (if applicable) [SIGNATORY 2 NAME], as identified by their [ID TYPES], personally appeared before me and acknowledged executing the aforementioned document or transaction on the given date.

II. PERSONALLY KNOWN STATEMENT

Alternatively, I confirm that [SIGNATORY 1 NAME] and (if applicable) [SIGNATORY 2 NAME] are personally known to me and have appeared before me on the said date, disclosing their identities of their own free will, for the execution of the above-mentioned document or transaction.

III. VOLUNTARY SIGNING STATEMENT

According to my knowledge and belief, the signatories have signed the document or transaction above willingly, without any coercion or undue influence.

IV. OATH OR AFFIRMATION STATEMENT

As needed for the specific document or transaction, I affirm that an Oath or an Affirmation was administered to the signatories, to confirm the truth of the contents of the document or transaction involved.

V. NOTARY PUBLIC SEAL AND SIGNATURE

State of [YOUR STATE], County of [YOUR COUNTY]

On the [DATE], before me, [YOUR NAME], a notary public for the state of [YOUR STATE], personally appeared [SIGNATORY 1 NAME] and (if applicable) [SIGNATORY 2 NAME], proved to me through government issued photo identification to be the person(s) whose name(s) is/are subscribed to the within document and acknowledged that he/she/they executed the same in his/her/their authorized capacity(ices).

My Commission Expires: [YOUR COMMISSION EXPIRY DATE]

Notary's Printed Name: [YOUR NAME]

Notary Seal (if applicable): [SEAL]

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