Pennsylvania Code § 57-316

Short form certificates.
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The following short form certificates of notarial acts are sufficient for the purposes indicated if completed with the information required by section 315(a) and (b) (relating to certificate of notarial act):
(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
‌
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)
‌
who represent that (he, she or they) are authorized to act on behalf of (name of party on behalf of whom record was executed) ‌
‌
Signature of notarial officer ‌
Stamp
‌
Title of office ‌
My commission expires: ‌
(2.1) For an acknowledgment by an attorney at law pursuant to 42 Pa.C.S. § 327 (relating to oaths and acknowledgments): ‌
State of ‌
County of ‌
This record was acknowledged before me on
(date) ‌
by (name of attorney) ‌
Supreme Court identification number ‌
as a member of the bar of the Pennsylvania Supreme Court certified that he/she was personally present when (name(s) of individual(s)) executed the record and that (name(s) of individual(s)) executed the record for the purposes contained therein.
Signature of notarial officer ‌
Stamp
‌
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
‌
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
‌
Title of office ‌
My commission expires: ‌
(5) For certifying a copy of a record:
State of ‌
County of ‌
I certify that this is a true and correct copy of a ‌
in the possession of ‌
Dated ‌
Signature of notarial officer ‌
Stamp
‌
Title of office ‌
My commission expires: ‌
(6) For certifying the transcript of a deposition:
State of ‌
County of ‌
I certify that this is a true and correct copy of the transcript of the deposition of ‌
Dated ‌
Signature of notarial officer ‌
Stamp
‌
Title of office: ‌
My commission expires: ‌

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