Mo. Rev. Stat. § 486.765: Certified copy form.

A notary shall use a certificate in substantially the following form in notarizing a certified copy:

State of Missouri

County (and/or City) of __________

On this ______ day of ______, 20 ____,

I certify that the (attached or following paper document) (affixed, attached, or logically associated electronic document) has been (visually) (electronically) confirmed by me to be a true, exact, and complete copy of the image (or text) (and metadata) of _____________ (description of original document), (presented/e-mailed to me by ______,) (found by me (online) at ________,) (held in my custody as a notarial record,) and that, to the best of my knowledge, the copied document is neither a vital record, a public record, nor a publicly recordable document, certified copies of which may be available from an official source other than a notary.

____________________ (official signature and seal of notary)