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
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