(3) A certificate of acknowledgment taken within this state shall be in the following form: ---------------------------------- |A notary public or other officer | |completing this | | | |certificate verifies only the | |identity of | |the | |individual who signed the | |document to which | |this | |certificate is attached, and not | |the | |truthfulness, | |accuracy, or validity of that | |document. | ----------------------------------
State of California )
County of___________ )
On______________________________________before me,
(here insert name and title of the officer),
personally appeared_____________________________,
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s)
is/are
subscribed to the within instrument and acknowledged to me that
he/she/they executed the same in his/her/their authorized
capacity(ies), and that by his/her/their
signature(s) on the
instrument the person(s), or the entity upon
behalf of which the
person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature________________________________ (Seal)