2011 Kansas Code
Chapter 53. - NOTARIES PUBLIC AND COMMISSIONERS
Article 5. - NOTARIAL ACTS
53-509 Short forms.
53-509. Short forms. The following short form certificates of notarial acts are sufficient for the purposes indicated, if completed with the information required by subsection (a) of K.S.A. 53-508:
(a) For an acknowledgment in an individual capacity:
State of ___________________________)
(County) of ________________________)
This instrument was acknowledged before me on ___(date)__ by ___ __[name(s) of person(s)]____
_________________________________. (Signature of notarial officer)
(Seal, if any)
_________________________________
Title (and Rank)
[My appointment expires: _______]
(b) For an acknowledgment in a representative capacity:
State of ___________________________
(County) of ________________________
This instrument was acknowledged before me on ___(date)__ by _______[name(s) of person(s)]_____ as (type of authority, e.g., officer, trustee, etc.) of (name of party on behalf of whom instrument was executed.)
_________________________________ (Signature of notarial officer)
(Seal, if any)
_________________________________
Title (and Rank)
[My appointment expires: _______]
(c) For a verification upon oath or affirmation:
State of ___________________________
(County) of ________________________
Signed and sworn to (or affirmed) before me on ___(date)__ by ___[name(s) of person(s)____ making statement].
_________________________________ (Signature of notarial officer)
(Seal, if any)
_________________________________
Title (and Rank)
[My appointment expires: ________]
(d) For witnessing or attesting a signature:
State of ___________________________
(County) of ________________________
Signed or attested before me on ___(date)___ by ____[name(s) of person(s)].
_________________________________ (Signature of notarial officer)
(Seal, if any)
_________________________________
Title (and Rank)
[My appointment expires: _______]
(e) For attestation of a copy of a document:
State of ___________________________
(County) of ________________________
I certify that this is a true and correct copy of a document in the possession of _______________________________.
Dated: ___________________
_________________________________ (Signature of notarial officer)
(Seal, if any)
_________________________________ Title (and Rank)
[My appointment expires: ________]
(f) For power of attorney in a representative capacity:
State of ___________________________
(County) of ________________________
This instrument was signed before me on ___(date)__ by _______[name(s) of designee(s)]____ as (power of attorney) of (name of party on behalf of whom instrument was executed.)
_________________________________ (Signature of notarial officer)
(Seal, if any)
_________________________________
Title (and Rank)
[My appointment expires: _______]
