2005 West Virginia Code - §29C-5-103. — Executing witness form.

§29C-5-103. Executing witness form.

(a) "Executing witness" as used in this section means an individual who acts in the place of a notary.
(b) An executing witness may not be related by blood or marriage or have a disqualifying interest as defined in subsection (b), section one hundred two, article three of this chapter.
(c) The affidavit of executing witness for acknowledgment by an individual who does not appear before a notary shall be substantially in the following form:
I, ______________________ (name of executing witness), do solemnly swear under the penalty of perjury, that ________________________ (name of person who does not appear before a notary), personally known to me, has executed the within __________________ (type of document) in my presence, and has acknowledged to me that ____ (he) executed the same for the purposes therein stated and requested that I sign my name on the within document as an executing witness.
__________________________________
(Signature of executing witness)
Subscribed and sworn before me this _______ day of ______________, 19____.
________________________________________________
(Official signature and official seal of notary)