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ADDITIONAL OPTIONAL INFORMATION
CAPACITY CLAIMED BY THE SIGNER
Individual (s)
Corporate Officer
______________________________
(Title)
□
Partner(s)
□
Attorney-in-Fact
□
Trustee(s)
□
Other _________________________
□
□
INSTRUCTIONS FOR COMPLETING THIS FORM
This form complies with current California statutes regarding notary wording and,
if needed, should be completed and attached to the document. Acknowledgements
from other states may be completed for documents being sent to that state so long
as the wording does not require the California notary to violate California notary
law.
º State and County information must be the State and County where the document
signer(s) personally appeared before the notary public for acknowledgment.
º Date of notarization must be the date that the signer(s) personally appeared which
must also be the same date the acknowledgment is completed.
º The notary public must print his or her name as it appears within his or her
commissi
on followed by a comma and then your title (notary public).
º Print the name(s) of document signer(s) who personally appear at the time of
notarization.
º Indicate the correct singular or plural forms by crossing off incorrect forms (i.e.
he/she/they, is /are ) or circling the correct forms. Failure to correctly indicate this
information may lead to rejection of document recording.
º The notary seal impression must be clear and pho
tographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re-seal if a
sufficient area permits, otherwise complete a different acknowledgment form.
º Signature of the notary public must match the signature on file with the office of
the county clerk.
•Additional information is not required but could help to ensure this
acknowledgment is not misused or attached to a different document.
•Indic
ate title or type of attached document, number of pages and date.
•Indicate the capacity claimed by the signer. If the claimed capacity is a
corporate officer, indicate the title (i.e. CEO, CFO, Secretary).
º Securely attach this document to the signed document with a staple.
DESCRIPTION OF THE ATTACHED DOCUMENT
________________________________________________
(Title or description of attached document)
________________________________________________
(Title or description of attached document continued)
Number of Pages _______ Document Date_____________
_____________________________
Notary Public Signature
(Notary Public Seal)
A notary public or other officer completing this certificate verifies only the identity
of the individual who signed the document to which this certificate is attached,
and not the truthfulness, accuracy, or validity of that document.
State of
County of _______________________
On __________________ before me, ____________________________________,
I certify under PENALTY OF PERJURY under the laws of the State of California that
the foregoing paragraph is true and correct.
(Here insert name and title of the officer)
the
CALIFORNIA
, NOTARY PUBLIC
CALIFORNIA ALL-PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT