Sample Notary Statements are available for the following
forms:
-
Acknowledgements
-
Oaths
-
Depositions
-
Affidavits
-
Certificates
Acknowledgments
An acknowledgment is a formal declaration before an
authorized official such as a notary, by a person who has
signed a document, that the document is his or her act.
Acknowledgments are governed by the Uniform Acknowledgment
Act. Five forms are listed in that act. The person
acknowledging the document must personally appear before the
notary.
In addition, the person may sign the document in the
notary’s presence, or acknowledge that the signature on the
document is his or her own.
To view the Uniform Acknowledgment Act,
click here.
SAMPLE ACKNOWLEDGMENT
Commonwealth of Pennsylvania)
)SS:
County of )
On this, the________day of __________, 20____, before me a
notary public, the undersigned officer, personally
appeared________________, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the
within instrument, and acknowledged that he executed the
same for the purposes therein contained.
In witness hereof, I hereunto set my hand and official seal.
___________________________
Notary Public
(1) For an individual acting in his
or her own right:
Commonwealth Of Pennsylvania
County Of __________
The foregoing instrument was acknowledged
before me this (date) by (name of person
acknowledging) , who is personally known to me or who
has produced (type of identification) as
identification.
(Signature of person taking acknowledgment)
(Name typed, printed or stamped)
(Title or rank)
(Serial number, if any)
(2) For a corporation:
Commonwealth Of Pennsylvania
County Of __________
The foregoing instrument
was acknowledged before me this (date) by (name of
officer or agent, title of officer or agent) of (name
of corporation acknowledging) , a (state or place of
incorporation) corporation, on behalf of the
corporation. He/she is personally known to me or has
produced (type of identification) as identification.
(Signature of person taking acknowledgment)
(Name typed, printed or stamped)
(Title or rank)
(Serial number, if any)
(3) For a partnership:
Commonwealth Of Pennsylvania
County Of __________
The foregoing instrument
was acknowledged before me this (date) by (name of
acknowledging partner or agent) , partner (or agent)
on behalf of (name of partnership) , a partnership.
He/she is personally known to me or has produced (type of
identification) as identification.
(Signature of person taking
acknowledgment)
(Name typed, printed or stamped)
(Title or rank)
(Serial number, if any)
(4) For an individual
acting as principal by an attorney in fact:
Commonwealth Of Pennsylvania
County Of __________
The foregoing instrument
was acknowledged before me this (date) by (name of
attorney in fact) as attorney in fact, who is personally
known to me or who has produced (type of identification)
as identification on behalf of (name of principal).
(Signature of person taking
acknowledgment)
(Name typed, printed or stamped)
(Title or rank)
(Serial number, if any)
(5) By any public
officer, trustee, or personal representative:
Commonwealth Of Pennsylvania
County Of __________
The foregoing instrument
was acknowledged before me this (date) by (name
and title of position) , who is personally known to me
or who has produced (type of identification) as
identification.
(Signature of person taking
acknowledgment)
(Name typed, printed or stamped)
(Title or rank)
(Serial number, if any)
(6) For an
acknowledgment in a representative capacity:
Commonwealth Of Pennsylvania
County Of __________
The foregoing instrument was acknowledged before me this
_____ day of __________, 20 __________, by (name of
person) as (type of authority, . . . e.g. officer,
trustee, attorney in fact) for (name of party on
behalf of whom instrument was executed).
(Signature of Notary Public - COMMONWEALTH OF
Pennsylvania)
(Print, Type, or Stamp Commissioned Name of Notary
Public)
Personally Known __________ OR Produced Identification
__________
Type of Identification Produced
Oaths
An oath is a formal declaration or promise to perform an act
faithfully and truthfully or an affirmation of the truth of
a statement. Oaths are usually given for three purposes: (1)
That a statement is the truth; (2) That the testimony he or
she will be giving will be the truth; (3) That he or she
will faithfully perform the duties of a public office.
SAMPLE OATHS
|
Notary: |
Do you
solemnly swear that the statements contained in this
affidavit are true to the best of your knowledge and
belief? |
|
Affiant: |
I do. |
|
Notary: |
Do you
solemnly swear that the testimony that you are about
to give will be the truth, the whole truth, and
nothing but the truth. |
|
Affiant: |
I do. |
Notary Public's Oath of Office
Commonwealth of Pennsylvania )
)SS:
County of )
I, Joe Q. Notary, having been duly appointed and
commissioned a Notary Public in and for the Commonwealth of
Pennsylvania, do solemnly swear (or affirm) that I will
support, obey and defend the Constitution of the United
States and the Constitution of this Commonwealth and that I
will discharge the duties of my office with fidelity.
Depositions
A
deposition is an involuntary sworn statement made by a
witness for use in the witness’ absence at a legal
proceeding.
In taking a deposition, the notary should first make sure
the witness is sworn in. The notary should then personally
record or supervise the recording of the testimony of the
witness. After the testimony is transcribed the notary
should let the witness read and sign the transcribed copy of
the deposition. The notary then certifies that the witness
was sworn and that this document is a true and record of the
witness’ testimony. The deposition should be sealed in an
envelope and filed with the court or sent to the
prothonotary for filing.
If a videotaped deposition is requested, the notary should
make sure the witness is sworn. However, it is unnecessary
to have a stenographic transcript and the witness’
signature. The videotape should be given to the attorney for
the party requesting the deposition.
The certificate for a transcribed deposition should comply
with the following format:
Commonwealth of Pennsylvania )
)SS:
County of )
Certificate of
Officer Before Whom Deposition is Taken
I,______________________(Name of Officer),
a_________________(Title) do hereby certify that, pursuant
to________________(Specify the stipulation, notice or order
of court under which the deposition was taken) the
deposition of __________(Name of Witness) was duly taken
at___________(Place) on___________(Date) at
___________o’clock ___m. before me. The
said__________________(Name of witness) was first duly sworn
(or affirmed) by me according to law to tell the truth, the
whole truth and nothing but the truth and thereupon did
testify as set forth in the above transcript of testimony.
The testimony was taken down in my presence stenographically
by_______(Name of stenographer) under my direction.
I
do further certify that the above deposition is full,
complete and true record of all the testimony given by the
said witness.
___________________________________
Officer
Affidavits
An affidavit is a voluntary, sworn written statement.
The name of the affiant, the person giving the statement,
must be mentioned in the affidavit and the affiant is
required to sign the affidavit in the notary’s presence.
Sample Affidavit
Commonwealth of Pennsylvania )
)SS:
County of )
Before me, the undersigned notary public, this day,
personally, appeared______________ to me known, who being
duly sworn according to law, deposes the following:
Affiant’s Statement)
(Signature of Affiant)
Subscribed and sworn to before me this__________day
of_______________,19___.
___________________________
Notary Public
CERTIFICATES
A
notary public may certify that a document is an accurate
copy of an original document, or that a statement is true.
The notary public must make sure that the copy is exactly
the same as the original.
Pennsylvania Notaries public may not certify certain
Federal, State or County records. Only the agencies where
these records are filed may certify copies, because they
alone hold the original documents or records. This would
include the following types of documents:
Sample
Certificate
Commonwealth of Pennsylvania )
)SS:
County of )
I certify that the attached copy of a ____________dated is a
true, correct and complete copy of the
original_________________________.
In witness whereof, I hereunto set my hand and official
seal.
___________________________
Notary Public
NEXT
