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On this (3)
day of (4)
in the year (5) ,
before me, the undersigned notary public, personally appeared
State of (1)
County of (2)
Subscribed and sworn to before me this (3) day of (4) in the year (5) .
State of (1)
County (and/or City) of (2)
I, (7) (name of notary), a Notary Public in and for said state, do certify that on (3,4,5) I carefully compared the attached facsimile of (8) and the facsimile I now hold in my possession. They are complete, full, true and exact facsimiles of the document they purport to reproduce.
(1) Name of the state in which the notary certificate is being completed.
(2) Name of the county in which the notary certificate is being completed.
(3) The date the notary certificate is being completed by the notary.
(4) The name of the month the notary certificate is being completed.
(5) The year the notary certificate is being completed.
(6) The name(s) of the person(s) who signed the document and whose signature you are acknowledging.
(7) Your official name style as a notary public.
(8) The name of the document you are notarizing (usually found at the top of the page you are notarizing, or the first of multiple pages).
(9) Your official signature as a notary public.
(10) Impress your notary engraved embosser seal or black inked rubber stamp seal here.
(11) Affix your rubber stamp here, or type/print the information required by law concerning your notary commission.
An application for a commission as a notary public can be downloaded from our website at www.sos.mo.gov/business/commissions. Additional applications may be obtained by calling 1-866-223-6535 (toll free) or (573) 751-2783, or by writing: Secretary of State, Commissions, PO Box 784, Jefferson City, MO 65102-0784.