§ 41-265 — Short form certificates

The following short form certificates of notarial acts are sufficient for the purposes indicated, if completed with the information required by section 41-264, subsections A and B:

1. For an acknowledgment in an individual capacity:

State of _____________________________________________

(County) of ___________________________________________

This record was acknowledged before me on _____________

Date

by ___________________________________

Name(s) of individual(s)

______________________________________

Signature of notarial officer

Stamp

(_____________________________________)

Title of office

(My commission expires: _____________)

2. For an acknowledgment in a representative capacity:

State of _________________________________________

(County) of ______________________________________

This record was acknowledged before me on _____________

Date

by ____________________________________________________

Name(s) of individual(s)

as (type of authority, such as officer or trustee) of (name of party on behalf of whom record was executed).

________________________________________

Signature of notarial officer

Stamp

(_______________________________________)

Title of office

(My commission expires: _______________)

3. 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 individual(s) making statement

__________________________________________

Signature of notarial officer

Stamp

(_________________________________________)

Title of office

(My commission expires: __________________)

4. For witnessing or attesting a signature:

State of _________________________________________

(County) of ______________________________________

Signed (or attested) before me on ________________

Date

by _______________________________________________

Name(s) of individual(s)

___________________________________________

Signature of notarial officer

Stamp

(__________________________________________)

Title of office

(My commission expires: ___________________)

5. 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 _______________________________

_____________________________________

Signature of notarial officer

Stamp

(____________________________________)

Title of office

(My commission expires: _____________)

6. For certifying a tangible copy of an electronic record:

State of _______________________________________________

(County) of ____________________________________________ I certify that the foregoing copy of a record (entitled ________) (dated _______) and containing ________ pages is an accurate copy of an electronic record.

Dated ____________________________________

__________________________________________

Signature of notarial officer

Stamp

(_________________________________________)

Title of office

(My commission expires: __________________)