The following short form certificates of notarial acts are sufficient for the purposes indicated, if completed with the information required by ORS 194.280 (1) to (3): ______________________________________________________________________________ (1) For an acknowledgment in an individual capacity: State of _________ County of _________ This record was acknowledged before me on (date) ______ by (name(s) of individual(s)) _________. Signature of notarial officer: ____________ Stamp (if required): Title of office: ____________ My commission expires: _________ (2) For an acknowledgment in a representative capacity: State of _________ County of _________ This record was acknowledged before me on (date) ______ by (name(s) of individual(s)) _________ as (type of authority, such as officer or trustee) _________ of (name of party on behalf of whom record was executed) ____________. Signature of notarial officer: ____________ Stamp (if required): Title of office: ____________ My commission expires: _________ (3) For a verification on oath or affirmation: State of _________ County of _________ Signed and sworn to (or affirmed) before me on (date) ______ by (name(s) of individual(s)) making statement _________. Signature of notarial officer: Stamp (if required): Title of office: ____________ My commission expires: _________ (4) For witnessing or attesting a signature: State of _________ County of _________ Signed (or attested) before me on (date) ______ by (name(s) of individual(s)) _________. Signature of notarial officer: ____________ Stamp (if required): Title of office: ____________ My commission expires: _________ (5) For certifying or attesting a copy of a record: State of _________ County of _________ I certify (or attest) that this is a true and correct copy of a record in the possession of ____________. Dated ______ Signature of notarial officer: ____________ Stamp (if required): Title of office: ____________ My commission expires: _________ ______________________________________________________________________________
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