I. Introduction

This is to certify that on this day, [Date], at [Place], before me, a Notary Public, personally appeared [Witness Name], known to me to be the person whose name is subscribed to the within instrument, and acknowledged that he/she executed the same for the purposes therein contained.

II. Certificate Details

III. Personal Details of the Witness

IV. Declaration

I, [Your Name], a Notary Public for said County and State, do certify that [Witness Name], as known to me to be the person whose name subscribed as the witness on the document, did sign this document in my presence. Further, no threats, promises, or duress of any kind has been used to compel the said [Witness Name] to sign this document.

V. Jurat

On [Date] of the month [Month] in the year [Year], we hereby acknowledge and identify the individual known to us as [Witness Name], who responsibly took an oath. Post their oral declaration, [Witness Name] has backed up the truth and precision of their shared data with their signature. This procedure was carried out under my close observation and was meticulously documented as per the established norms and guidelines.

VI. Conclusion

Upon appending my signature below this document, I am solemnly confirming and endorsing the fact that I was physically present and witnessed the act of the signing of the document referred to above by the designated witness. Furthermore, through my verification, I ascertain and assure the authenticity and accuracy of their signature, as mentioned in the preceding parts of this statement.

VII. Signature of Notary

Name: [Notary Public Name]

Date: [Date of Notarization]

Notary Seal:
[Attach Notary Seal Here]

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