My commission expires:................................
(2.1) For an acknowledgment by an attorney at law
pursuant to 42 Pa.C.S. § 327 (relating to oaths and
acknowledgments):......................................
State of...............................................
County of..............................................
This record was acknowledged before me on
(date).................................................
by (name of attorney)..................................
Supreme Court identification number....................
as a member of the bar of the Pennsylvania Supreme Court
certified that he/she was personally present when
(name(s) of individual(s)) executed the record and that
(name(s) of individual(s)) executed the record for the
purposes contained therein.
Signature of notarial officer..........................
Stamp
.......................................................
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
......................................................
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
......................................................
Title of office.......................................
My commission expires:................................
(5) For certifying a copy of a record:
State of..............................................
County of.............................................
I certify that this is a true and correct copy of a...
in the possession of..................................
Dated.................................................
2017/90AJB/SB0595A01569 - 3 -
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