5 ILCS 312/6-105: Short Forms.

The following short form certificates of notarial acts are sufficient for the purposes indicated.

(a) For an acknowledgment in an individual capacity:

State of _________________

County of ________________

This instrument was acknowledged before me on ___________(date) by ___________________(name/s of person/s).

____________________________ (Signature of Notary Public) (Seal)

(b) For an acknowledgment in a representative capacity:

State of ______________________

County of _____________________

This instrument was acknowledged before me on _________(date) by __________________(name/s of person/s) as _________________________________(type of authority, e.g., officer, trustee, etc.) of _________________________(name of party on behalf of whom instrument was executed).

_______________________________ (Signature of Notary Public) (Seal)

(c) For a verification upon oath or affirmation:

State of _________________

County of_________________

Signed and sworn (or affirmed) to before me on _________(date) by _____________________(name/s of person/s making statement).

_______________________________ (Signature of Notary Public) (Seal)

(d) For witnessing or attesting a signature:

State of_________________

County of _______________

Signed or attested before me on __________(date) by __________________(name/s of person/s).

_______________________________ (Signature of Notary Public) (Seal)