Short form certificates. 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)

ORS 194.285 — under Chapter 194.

ORS 194.285

______________________________________________________________________________

(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: _________

______________________________________________________________________________ [2013 c.219 §15]