Sample Forms
“(Personalized Seal)” in the following examples means a seal containing the
words "Notary Public, State of Texas" around a star of five points, the notary
public's name, and the date the notary public's commission expires. For
notaries commissioned or recommissioned on and after January 1, 2016,
the seal must also contain the notary public’s Secretary of State ID number.
ACKNOWLEDGMENTS
I. Form for Ordinary Certificate of Acknowledgment
State of Texas
County of
Before me, (insert the name and character of the officer), on this day personally
appeared _, known to me (or proved to me on the oath of
or through (description of identity card or other document) to
be the person whose name is subscribed to the foregoing instrument and
acknowledged to me that he executed the same for the purposes and
consideration therein expressed.
Given under my hand and seal of office this day of ,
(year).
(Personalized Seal) Notary Public's Signature
II. Short Forms
A.
For a natural person acting in his/her own right:
State of Texas
County of
This instrument was acknowledged before me on (date) by (name or names of
person or persons acknowledging).
(Personalized Seal) Notary Public's Signature
B.
For a natural person as principal acting by attorney-in-fact:
State of Texas
County of
This instrument was acknowledged before me on (date) by (name of attorney-in-
fact) as attorney-in-fact on behalf of (name of principal).
(Personalized Seal) Notary Public's Signature
C.
For a partnership acting by one or more partners, an authorized officer, or
an agent:
State of Texas
County of
This instrument was acknowledged before me on (date) by (name of
acknowledging partner, partners, authorized officer, or agent),
(partner(s), authorized officer, or agent) on behalf of (name of partnership), a
partnership.
(Personalized Seal) Notary Public's Signature
D.
For a corporation:
State of Texas
County of
This instrument was acknowledged before me on (date) by (name of officer), (title
of officer) of (name of corporation acknowledging), a (state of incorporation)
corporation, on behalf of said corporation.
(Personalized Seal) Notary Public's Signature
E.
For a limited liability company:
This instrument was acknowledged before me on (date) by (name of
acknowledging member, manager, authorized officer, or agent) a (member,
manager, authorized officer, or agent) of (name of limited liability company), a
limited liability company.
(Personalized Seal) Notary Public's Signature
F.
For a public officer, trustee, executor, administrator, guardian, or other
representative:
State of Texas
County of
This instrument was acknowledged before me on (date) by (name of
representative) as (title of representative) of (name of entity or person
represented).
(Personalized Seal) Notary Public's Signature
G.
Form of Certificate for Proof by Witness
State of Texas
County of
Before me, (insert the name and character of the officer), on this day personally
appeared _, known to me (or proved to me on the oath of
), to be the person whose name is subscribed as a witness to
the foregoing instrument of writing, and after being duly sworn by me stated on
oath that he saw , the grantor or person who executed the foregoing
instrument, subscribe the same (or that the grantor or person who executed such
instrument of writing acknowledged in his presence that he had executed the
same for the purposes and consideration therein expressed), and that he had
signed the same as a witness at the request of the grantor (or person who
executed the same.)
Given under my hand and seal of office this day of ,
(year).
(Personalized Seal) Notary Public's Signature
JURAT
State of Texas
County of
Sworn to and subscribed before me on the day of
, (year), by (name of signer).
(Personalized Seal)
Notary Public's Signature
VERIFICATIONS
Form 1:
State of Texas
County of
, personally appeared before me, and being first duly sworn
declared that he/she signed this application in the capacity designated, if any,
and further states that he/she has read the above application and the statements
therein contained are true.
(Personalized Seal) Notary Public's Signature
Form 2:
State of Texas
County of
Before me, a notary public, on this day personally appeared ,
known to me to be the person whose name is subscribed to the foregoing
document and, being by me first duly sworn, declared that the statements therein
contained are true and correct.
(Personalized Seal) Notary Public's Signature
OATH OR AFFIRMATION
State of Texas
County of
I, (affiant), do solemnly swear (or affirm), that I will faithfully execute the duties of
the office of of the State of Texas, and will to the best of
my ability preserve, protect, and defend the Constitution and laws of the United
States and of this State, so help me God.
Signature of Affiant
Sworn to and subscribed before me by (affiant) on this day of
, (year).
(Personalized Seal) Notary Public's Signature
DEPOSITION
Certificate to Deposition Upon Written Questions
State of Texas
County of
(Plaintiff) ) In the Court
v. ) of County, Texas
(Defendant) ) Cause No.
I hereby certify that the foregoing answers of , the witness
forenamed, were signed and sworn to before me on (date), by said witness.
(Personalized Seal) Notary Public's Signature
PROTESTS
(Insert bill or note or copy thereof)
United States of America
State of Texas
County of
Be it known that on the day of , (year), at the request of
(name), of , I, (notary public's name), a notary public duly
commissioned and sworn, residing in County, Texas, did present
the original (instrument), hereto attached, for $ , with accrued interest
thereon of $ , dated , and demanded payment (or
acceptance) thereof, which was refused.
Whereupon I, at the request of the aforesaid , did protest, and by
these presents do protest, as well against the drawer, maker, endorsers, and
acceptors of said instruments as against all others whom it may concern, for
exchange, costs, charges, damages, and interest already incurred and
hereinafter to be incurred by reason of non-payment thereof. I further certify that
on (date), notice in writing of the foregoing presentment, demand, refusal and
protest was given by (persons and status) by depositing notices thereof in the
post office at , Texas, postage paid, directed as follows:
. I further certify that notices were left as follows:
Notice left for at
Notice left for at
Each of the named places the reputed place of residence of the person for whom
the notice was left.
In testimony whereof I have hereunto set my hand and affixed my seal of office at
, Texas, on day of , (year).
(Personalized Seal) Notary Public's Signature
CERTIFIED COPY OF A NOTARIAL RECORD
State of Texas
County of
On this day of , (year), I certify, pursuant to Tex. Gov’t
Code §406.014(c), that the preceding or attached document is a true, exact,
complete, and unaltered copy made by me of (description of notarial record), the
original of which is held in my custody as a notarial record.
(Personalized Seal) Notary Public's Signature
CERTIFIED COPY OF A NON-RECORDABLE DOCUMENT
State of Texas
County of
On this day of , (year), I certify that the preceding or
attached document, is a true, exact, complete, and unaltered copy made by me
of (description of document), presented to me by the document's custodian,
, and that, to the best of my knowledge, the photocopied
document is neither a public record nor a publicly recordable document, certified
copies of which are available from an official source other than a notary.
(Personalized Seal) Notary Public's Signature
DECLARATION OF AUTHENTICITY BY A NOTARY PUBLIC
(Declaration that is to be attached to a printed paper copy of an electronic
record that is to be recorded in the real property records on the county level
pursuant to Sec. 12.0013, Texas Property Code.)
State of Texas
County of
The attached document, (insert title of document), dated (insert date of document)
and containing ____ pages, is a true and correct copy of an electronic record
printed by me or under my supervision. At the time of printing, no security
features present on the electronic record indicated any changes or errors in an
electronic signature or other information in the electronic record after the
electronic record’s creation or execution.
This declaration is made by me under penalty of perjury, and signed this
day of , (year).
(Personalized Seal) Notary Public's Signature
Printed Name of Notary Public
