Utah Code § 57-2-13

Form for certificate of proof
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The certificate of proof shall be substantially in the following form, to wit:
 State of Utah, County of ____
 On this __________(month\day\year), before me personally appeared ____, personally
known to me (or satisfactorily proved to me by the oath of ____, a competent and credible
witness for that purpose, by me duly sworn) to be the same person whose name is subscribed
to the above instrument as a witness thereto, who, being by me duly sworn, deposed and said
________ resides in ____, county of ____, and state of Utah; that as a subscribing witness was
present and saw ____, personally known to the subscribing witness to be the signer of the above
instrument as a party thereto, sign and deliver the same, and heard the party acknowledge that
the party executed the same, and that the subscribing witness thereupon signed his/her name as a
subscribing witness thereto at the request of said ____.

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