The following short form certificates of notarial acts are sufficient for the purposes indicated, if completed with the information required by ORS 194.280 (1) to (3):
______________________________________________________________________________
(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 (if required):
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 (if required):
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 (if required):
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 (if required):
Title of office: ____________
My commission expires: _________
(5) For certifying or attesting a copy of a record:
State of _________
County of _________
I certify (or attest) that this is a true and correct copy of a record in the possession of ____________.
Dated ______
Signature of notarial officer: ____________
Stamp (if required):
Title of office: ____________
My commission expires: _________
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