Kansas Administrative Regulations › Agency 7 - SECRETARY OF STATE › Article 43 - NOTARIES PUBLIC › Section 7-43-17 - Short form notarial certificates; statement for notarial act for a remotely located individual

Current through Register Vol. 43, No. 28, July 11, 2024
(a)
			 The following short form notarial certificates shall be sufficient for the
			 purposes indicated, if completed in conformance with the procedures required
			 for a notarial act:
(1) For an acknowledgment
			 in an individual capacity:
"State of ________________________________________
County of ______________________________________
This record was acknowledged before me on
________ by ______________________________
Date Name(s) of person(s)
__________________________________
Signature of notarial officer
[official 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
________ by ______________________________
Date Name(s) of person(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
[official 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
________ by ______________________________
Date Name(s) of person(s)
making statement
__________________________________
Signature of notarial officer
[official Stamp]
__________________________________
Title of office
My commission expires: _________ "
(4) For witnessing or attesting a signature:
"State of _________________________________________
County of _______________________________________
Signed (or attested) before me on ________ by
				_____________________
Date Name(s) of person(s)
__________________________________
Signature of notarial officer
[official 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
[official Stamp]
__________________________________
Title of office
My commission expires: _________ "
(6) For power of attorney in a representative
			 capacity:
"State of _________________________________________
County of _______________________________________
This instrument was signed before me on
________ by ________________________
Date Name(s) of designee(s)
as power of attorney of
				________________________________________
name of party on behalf of whom instrument was executed.
_________________________________
Signature of notarial officer
[official Stamp]
__________________________________
Title of office
My commission expires: _________ "