Example Notarizations
Acknowledgement:
State of Hawaii
City and County SS
of Honolulu
I, John Smith Doe, hereby appoint Jane Doe to be my health care power of attorney. This is only to take effect when I am no longer able to make my own health care decisions. Jane Doe will be able to make all health care and end of life decisions for me once this power of attorney is evoked
_____________________________
John Smith Doe Date
On ____ day of _______________, 20__, before me appeared John Smith Doe, personally known to me (or proven on the basis of satisfactory evidence) to be the person whose name is subscribed to this instrument and acknowledged that he executed it under his free act and deed.
Witness my hand and seal
_______________________
Notary Public Signature
(Notary Printed Name)
My commission Expires: June 2, 2024
NOTARIAL CERTIFICATE
Document Date:____________ # Pages______
(Notary Name)
____ Judicial Circuit
Document Description: ____________________
___________________________________________
___________________________________________
Notary Signature
Date
Acknowledgement by Power of Attorney:
(Requires a Power of Attorney granting the specific permissions to be presented)
State of Hawaii
City and County SS
of Honolulu
I, John Doe, hereby sell my 1963 Aston Martin DB5 to my nephew, Jacob Doe, for the amount of ten ($10) dollars.
_____________________________
John Smith Doe Date
On this _____ day of __________, 20___, before me personally appeared Jane Smith, to me personally known to be the person who executed the foregoing instrument on behalf of John Doe and acknowledged that she executed the same as the free act and deed of said John Doe. In witness whereof, I have hereunto set my hand and seal.
_______________________
Notary Public Signature
(Notary Printed Name)
My commission Expires: June 2, 2024
NOTARIAL CERTIFICATE
Document Date:____________ # Pages______
(Notary Name)
____ Judicial Circuit
Document Description: ____________________
___________________________________________
___________________________________________
Notary Signature
Date
Jurat:
State of Hawaii
City and County SS
of Honolulu
I, John Smith Doe, swear that
- I am the affiant herein
- I am the person that executed this document, and
- The document is true and accurate to the best of my knowledge.
Further sayeth not.
_____________________________
John Smith Doe Date
Subscribed to and affirmed to before me this ______ day of _____________, 20__.
_______________________
Notary Public Signature
(Notary Printed Name)
My commission Expires: June 2, 2024
NOTARIAL CERTIFICATE
Document Date:____________ # Pages______
(Notary Name)
____ Judicial Circuit
Document Description: ____________________
___________________________________________
___________________________________________
Notary Signature
Date
Jurat with notarial certificate included:
State of Hawaii
City and County SS
of Honolulu
I, John Smith Doe, swear that
- I am the affiant herein
- I am the person that executed this document, and
- The document is true and accurate to the best of my knowledge.
Further sayeth not.
_________________________
John Doe
Date
Subscribed and sworn to before me on this ____ day of ___________, 20__, appeared John Doe, who
executed this ____ page document dated _____ and titled _______ in the first circuit of the State of
Hawaii.
_______________________
Notary Public Signature
(Notary Printed Name)
My commission Expires: June 2, 2024
