SHORT FORM NOTARY
ACKNOWLEDGEMENT

I. Introduction

I, the undersigned [Your name], a Notary Public, do hereby certify that on this January 1st, 2050 day, personally appeared before me [Signer's name], with identification no. [Signer's identification number], known (or proved) to me to be the person whose name is subscribed to the within the instrument.

II. Acknowledgement of Execution

The said [Signer's name] has acknowledged that he/she executed the instrument for the purposes therein contained. The signer further affirmed the authenticity of their signature and the contents of the document.

III. Notary Detail Information

Notary Detail Information
Notary Name	[Your Name]
Notary Public State	[Your State]
Notary ID Number	[Your ID number]
Notary Commission Expiry Date	[Your Commission Expiry Date]

IV. Notary's Testimony and Signature

In testimony whereof, I have hereunto set my hand and affixed my official seal in the county of [Your county], state of [Your state], this January 1st, 2050.