State of [State name], County of [County name]
On this day, personally appeared before me
____________________________________________________________,
to me known to be the person(s) described in and who performed the within and preceding document, and accepted that he/she signed the same as his/her voluntary act and action, for the uses and purposes mentioned within.
Witness my hand and official seal hereto affixed
this ______ day of ____________, _________.
__________________________________________
Notary Public in and for the State of _________________.
My commission expires _______________.
Download Sample General Notary Statement Letter In Word Format 1