Notary: [Your Name]
Notary Commission Number: [Your Commission Number]
Commission Expiration Date: [MM/DD/YYYY]
Date: [MM/DD/YYYY]
Time: [HH: MM AM/PM]
Type of Notarial Act:
Acknowledgment
Jurat
Oath or Affirmation
Copy Certification
Signature Witnessing
Other (Specify): [Specify Type]
Document Type: [Type of Document Notarized]
Signatory Name(s):
Principal: [Principal Signatory Name]
Other Party: [Other Party Name(s)]
Identification Presented:
Type of ID: [Type of Identification Document]
ID Number: [ID Number]
Issued By: [Issuing Authority]
Date of Issuance: [MM/DD/YYYY]
Expiration Date: [MM/DD/YYYY]
Additional Notes: [Additional Information or Remarks]
Notary Signature:
Signatory Signature(s)
Principal:
Confirmation of Identity:
Personally Known
Satisfactory Evidence of Identity
Credible Witness(es) (Specify): [Name(s) of Witness(es)]
Method of Identification:
Examination of ID
Reliance on ID Issuer
Credible Witness(es)
Fee Charged: [Amount Charged, if applicable] -
Mode of Payment: [Payment Method]
[Entry Number]
Received by: [Your Company Name]
Date Received: [MM/DD/YYYY]
This journal entry is a true and accurate record of the notarial act performed by me on the date stated above.
[Your Name]
Notary Public
[Your Company Name]
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