[Your Name]
[Your Title (if applicable)]
[Your Company Address]
[Your Company Number]
[Your Company Email]
Document Title: [Document Title]
Number of Pages: [Number of Pages]
Date of Document: [Date of Document]
[Principal's Name]
[Principal's Address]
[Principal's City, State, ZIP Code]
I, [Your Name], a Notary Public for the State of [State], do certify that on this [Date] day of [Month], [Year], [Principal's Name], known to me to be the person whose name is subscribed to the foregoing instrument, appeared before me in person and acknowledged that he/she executed the same for the purposes stated therein.
[Your Name], Notary Public
My commission expires [Date Your Commission Expires]
(Notary Seal)
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