Notary Public Central   

 

 

 
             

 

 

 

Introduction  |  Course Outline  |  What is a Notary  |  Concepts  |  Definitions

 

Sample Forms  |  Subsections  |  Notary Facts  |  Test Prep  |  Review

 

ACKNOWLEDGMENT

 

#1 Notary to fill!

 

STATE OF                                        )  (Venue/jurisdiction)

COUNTY OF                                    )

 

Sample

I   John Doe                   , acknowledge that I signed the foregoing lease for a 2000 Mercedes Benz vin #1ZK……..

 

 

    John Doe                                                 #2 Could have signed at home!

Affiant’s signature

 

#3 Notary to take ID & execute Notary Certificate!

 

 


 

Sample

Acknowledged and affirmed to before me appeared ________________ on this                day of ______200__.     

(Notary certificate)

 

                                 . 

Notary Public                               #4 Notary to sign in Blue or Black               

                                                Permanent Non-erasable - non-marker pen!

[STAMP BELOW SIGNATURE IN BLACK INK THE FOLLOWING:]

Your Name

Notary Public, State of New York

Commission No.: ________

Qualified in ___________ County

Commission Expires: ________

 

 

§303 Requisites of acknowledgements: Do not take acknowledgement unless you personally know constituent (several years) or they have been properly identified.

Interest as a disqualification: A notary cannot have a personal, emotional, financial, beneficial, direct interest in what they are notarizing.

Fraudulent certificates of acknowledgment: When a notary intentionally acknowledges the signature of a fraudulent constituent. (Forgery = Class D felony = 7 years prison)


 

 

 

AFFIDAVIT

 

 

#1 Notary to fill!

 

Sample
STATE OF                                       )  (Venue/jurisdiction)

COUNTY OF                                  )

 

 

I    Jane Doe                     , affirm that I have not been known by any other name for the past Ten (10) years.

 

 

 Jane Doe                                          #2 Must sign in Notaries presence!       

Affiant’s signature

 

#3 Notary to administer an oath, take ID & execute Jurat!

 

 

 

Sample
Sworn/Subscribed to before me personally appeared _________on this                day of                    200__.      

(Jurat)

 

                                 .               #4 Notary to sign in Blue or Black              

Notary Public                          permanent Non-erasable - Non marker pen!

 

[STAMP BELOW SIGNATURE IN BLACK INK THE FOLLOWING:]

Your Name

Notary Public, State of New York

Commission No.: ________

Qualified in ___________ County

Commission Expires: ________

 


 

Apostille

 

(Convention de La Hayed u 5 October 1961)

 

1. Country:           United State of America

 

Sample
          This public document

 

2. has been signed by _________________________

 

3. acting in the capacity of County Clerk

 

4. bears the seal/stamp of the county of New York

 

 

Certified

 

    5.    at New York, New York

 

    6.    the 14th day of June 2006

 

 

    7.    by Special Deputy Secretary of State, State of New York

 

8.    No. _________

Sample

9.    Seal/Stamp                            10. Signature

 

 

                                                                                        Bla Bla Bla----

                                                        Bla Bla Bla

                                                        Special Deputy Secretary of State

 


 

 

 

Attestation Clause

 

ATTESTING WITNESSES SHOULD READ CAREFULLY BEFORE SIGNING THIS AFFIDAVIT – NOTARY SHOULD NOT BE A PARTY OR WITNESS – NOTARIES DO NOT EXECUTE THIS DOCUMENT!

 

STATE OF NEW YORK

COUNTY OF ________

 

          Each of the undersigned, individually and severally being duly sworn, deposes and says:

 

Sample
            The within Will was subscribed in our presence and sight at the end thereof by _____________________, the within-named Testator/Testatrix, on the ____ day of __________, 20 __, at ________________________[address].

 

            Said Testator/Testatrix at the time of making such subscription declared the instrument so subscribed to be his/her Last Will and Testament.

 

            Each of the undersigned thereupon signed his or her name as a witness at the end of said Will at the request of said Testator/Testatrix and in his/her presence and sight and in the presence and sight of each other.

 

            Said Testator/Testatrix was, at the time of so executing said Will, over the age of 18 years and, in the respective opinions of the undersigned, of sound mind, memory and understanding and not under any restraint or in any respect incompetent to make a will.

 

            The Testator/Testatrix, in the respective opinions of the undersigned, could read, write and converse in the English language and was suffering from no defect of sight, hearing or speech or from any other physical or mental impairment which would affect his/her capacity to make a valid will.  The Will was executed as a single, original instrument and was not executed in counterparts.  Each of the undersigned was acquainted with said Testator/Testatrix at said time and makes this affidavit at his/her request.  The within Will was shown to the undersigned at the time affidavit was made, and was examined by each of them as to the signature of said Testator/Testatrix and of the undersigned.

Sample

 

                                                                        __________________________________

                                                                        Witness

 

                                                                        __________________________________

                                                                        Witness

 

            Severally sworn to before me on this ____ day of _______________, 20_____.

 

           

 

                                                                        __________________________________

                                                                        NOTARY PUBLIC

My Commission Expires:

____________________

 


 

Bill of Sale

 

(WITH WARRANTY OF TITLE)
 
Sample
          I,__________________, of _____________________________, County 
 
of_______________, State of _______________________, in consideration of 
 
$_________________, to me paid by_______________________, the receipt of 
 
which is hereby acknowledged, do hereby grant, sell, transfer and deliver unto 
 
______________the following goods and chattels, namely,
 
           ___________________________________________
 
           ___________________________________________
 
 
          To have and to hold the same to _________________and his heirs, executors, administrators, successors
 and assigns, to their use forever.
 
          And I hereby covenant with the grantee that I am the lawful owner of said goods; that they
 
are free from all encumbrances; that I have good right to sell the same as aforesaid; and that I will warrant and defend 
the same against the lawful claims and demands of all persons.
 
          IN WITNESS WHEREOF, I ________________________ hereunto set my 
 
Sample
hand, this _____ day of ___________, 20____.
 
 
_________________________________
Notary Public
 
 
 
 
 

CODICIL

TO

Sample
LAST WILL AND TESTAMENT OF

 

________________________

 

          I, _______________, of __________________ county, New York, declare this as a Codicil to my Will dated _________.  This Codicil amends or supplements my Will only as provided herin.  Except as amended or supplemented, my Will referenced herein shall remain in full force and effect.

 

ARTICLE I.

 

 

NOTARIES DO NOT EXECUTE THIS DOCUMENT!

Sample

                                               

 

                                                ___________________________

                                                          Witness

 

                                                          ___________________________

                                                          Witness

 

          Severally sworn to before me on this ____ day of __________, 20_____.

 

Sample
         

 

                                                                                                                                                                                                                                             ___________________________

                                                                                              NOTARY PUBLIC

My Commission Expires:

____________________

 
 
 
 
 
 
 
 
 Judgment Affidavit
 
 
Sample
STATE OF NEW YORK                   )                              Title No.________________
COUNTY OF _________________)
 
The undersigned, being duly sworn, depose(s) and say(s) that:
 
1.      The undersigned [was/were] named as grantee(s) in a certain deed recorded in the ____________ County _______ Office in Liber _____of Deeds at page __, conveying premises commonly known as _______________________________, and  ________________________________________;
 
2.      The undersigned [is/are] the owner(s) in fee of the premises described in said deed; and
 
3.      The attention of the undersigned has been called to certain judgments, tax liens, warrants, bankruptcies and/or incompetencies against persons with names similar to those of the undersigned; and
 
4.      None of said judgments, tax liens or warrants are against the undersigned and there are no judgments, tax liens, warrants or other encumbrances or liens of any nature whatsoever against the undersigned; and
 
5.      [Neither of the undersigned] [has/has not] been adjudicated incompetent or bankrupt and [neither of] the undersigned [has/has not] filed any petition in bankruptcy nor has an involuntary petition in bankruptcy been filed against [either of] the undersigned.
 
6.      The affidavit is made with the express understanding of the undersigned that a purchaser or a mortgage of said premises will rely upon the truth and accuracy of all of the statements contained herein in closing the purchase of said premises.
 
Sample
                                                                                      _____________________
 
                                                                                      _____________________
 
Subscribed and sworn to before me this
_____day of _____, 20__.
 
 
________________________________
NOTARY PUBLIC
 
 
                                                                                     

 

 

 

POWER OF ATTORNEY
 
 
I __________________, of _______________ hereby appoint ___________, 
of _____________, as my attorney in fact to act in my capacity to do every act that I 
may legally do through an attorney in fact.  This power shall be in full force and effect 
on the date below written and shall remain in full force and effect until _____________
or unless specifically extended or rescinded earlier by either party.
 
Dates _____________________, 20____.
 
_________________________________
 
 
STATE OF ________________________
 
COUNTY OF ______________________
 
BEFORE ME, the undersigned authority, on this ____ day of __________, 20____, 
personally appeared _______________ to me well known to be the person described 
in and who signed the Foregoing, and acknowledged to me that he/she executed the same 
freely and voluntarily for the uses and purposes therein expressed.
 
 
 
WITNESS my hand and official seal the date aforesaid.
 
 
________________________________
NOTARY PUBLIC
 
My Commission Expires _________. 


 

 

PROMISSORY NOTE
 
 
 
$00,000.00                                                                                 [CITY, STATE]
                                                                                                     [DATE]
 
 
 
         For VALUE RECEIVED, the undersigned (jointly and severally, if more than one) promises to pay 
to ___________________the principal sum of ___________________________DOLLARS, ($00,000.00) 
with interest from date at the rate of ______(%) percent per annum on the balance form time to time remaining 
unpaid.  The said principal and interest shall be payable in lawful money of the United States of America 
at ________________ or at such place as may hereafter be designated by written notice from the holder to the
 maker hereof, on the date and in the manner following:
 
UPON DEMAND AFTER --------------------.
 
Maker’s Address                         _____________________(SEAL)
 
                                                       _____________________(SEAL)
 
                                                       _____________________(SEAL)


 

 

 

LIVING WILL

 

I, __________, of __________, being of sound mind, do hereby willfully and

voluntarily make known my desire that my life not be prolonged under any of

the following conditions, and do hereby further declare:

 

1.  If I should, at any time, have an incurable condition caused by any

disease or illness, or by any accident or injury, and be determined by any

two or more physicians to be in a terminal condition whereby the use of

"heroic measures" or the application of life-sustaining procedures would

only serve to delay the moment of my death, and where my attending

physician has determined that my death is imminent whether or not such

"heroic measures" or life-sustaining measures are employed, I direct that

such measures and procedures be withheld or withdrawn and that I be

permitted to die naturally.

 

2. In the event of my inability to give directions regarding the

application of life-sustaining procedures or the use of "heroic measures",

it is my intention that this directive shall be honored by my family and

physicians as my final expression of my right to refuse medical and

surgical treatment, and my acceptance of the consequences of such refusal.

 

3. I am mentally, emotionally and legally competent to make this directive

and I fully understand its import.

 

4. I reserve the right to revoke this directive at any time.

 

5. This directive shall remain in force until revoked. 

 

IN WITNESS WHEREOF, I have hereto set my hand and seal this _____ day of

__________, 20___.

 

Signed: __________

 

Declaration of Witnesses

 

The declarant is personally known to me and I believe him to be of sound

mind and emotionally and legally competent to make the herein contained

Directive to Physicians.  I am not related to the declarant by blood or

marriage, nor would I be entitled to any portion of the declarant's estate

upon his decease, nor am I an attending physician of the declarant, nor an

employee of the attending physician, nor an employee of a health care

facility in which the declarant is a patient, nor a patient in a health

care facility in which the declarant is a patient, nor am I a person who

has any claim against any portion of the estate of the declarant upon his

death.

 

Signed: _____________

 
 


 

 

 

 

 

 
 
New York State Health Care Proxy Form
 
1.      I, _______________________ hereby appoint
 
____________________________________________________
        (name, home address and telephone number)
as my health care agent to make any and all health care decisions for me, except to the extent that I state otherwise.  This 
proxy shall take effect when and if I become unable to make my own health care decisions.
 
2.      Sample
Optional instructions: I direct to make health care decisions in accord with my wishes and limitations 
as stated below, or as he or she otherwise knows. (Attach additional pages if necessary.)
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
 
(Unless your agent knows your wishes about artificial nutrition and hydration (feeding tubes), your agent will not be allowed
 to make decisions about artificial nutrition and hydration.

 

3.      Name of substitute or fill-in-agent if the person I appoint above is unable, unwilling or unavailable to act as my health care agent.

 

_______________________________________________________________

(name, home address and telephone number)

_______________________________________________________________

 

4.      Unless I revoke it, this proxy shall remain in effect indefinitely, or until the date or conditions stated below.  This proxy shall expire (specific date or conditions, if desired):

________________________________________________________________

 

5.      Signature _________________________________________

Address_________________________________________________________

Date____________________________

 

Statement by Witness (must be 18 or older)

 

I declare that the person who signed this document is personally known to me and appears to be of wound mind and acting of his or her own free will.  He or she signed (or asked another to sign for him or her) this document in my presence.

Sample

Witness 1_________________________________________________________

Address___________________________________________________________

Witness 2_________________________________________________________

Address __________________________________________________________