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Sample Forms
  •  Acknowledgement
  •  Verification upon Oath or Affirmation
  •  Witnessing or Attesting a Signature
  •  Signature-by-Mark


An Illinois notary public is authorized to perform notarial acts
or “notarization” anywhere in the state. Notarial acts include taking an
acknowledgment, taking a verification upon oath or affirmation, witnessing or
attesting a signature, administering an oath or affirmation, and performing any
other act authorized by law (Sec. 6-101).

A notary public must positively identify the person requesting notarization.
A notary has positive identification if the person (a) is personally known to the notary; (b) is identified upon the oath or affirmation of a credible witness personally known to the notary; or (c) is identified on the basis of identification documents (Sec. 6-102).

There is a certificate for each type of notarial act. Most documents have a preprinted certificate on the form, or a certificate has been prepared by an attorney. It is not the notary’s function to determine what type of notarial act is required with regard to a request, but the notary must know and use the proper certificate for the type of act he or she is requested to perform (Sec. 6-103). A brief description of each type of notarial act and the related certificate follows.

For additional information, please see the Illinois Notary Handbook:
 
 

 
Acknowledgment
The taking of an acknowledgment consists of positively identifying the signer of
a document. The signer need not sign in the notary’s presence but must personally
appear before the notary and state that the signature on the document is his or
hers. Acknowledgments may be taken in an individual capacity or in a
representative capacity (as an authorized representative of another – for example,
as officer of a corporation for and on behalf of the corporation or as an attorney
in fact for another person). These short form certificates are sufficient to
meet the requirements of the law.
 

acknowledgment
(in an individual capacity)
 

State of Illinois

County of ___________________.

This instrument was acknowledged before me on _________________
______________________ (date) by ___________________________
(name of person).
(seal)
    ________________________
    signature of notary public

  * * *
acknowledgment
(in a representative capacity)
 

State of Illinois

County of ___________________.

This instrument was acknowledged before me on _________________

______________________ (date) by ___________________________

(name of person) as _________________________ (type of authority,

e.g., officer, trustee, etc.) of ___________________________________

(name of party on behalf of whom instrument was executed).

(seal)
    ________________________
    signature of notary public
 
 
 

  Verification Upon Oath of Affirmation
Sometimes referred to as a “jurat,” verification upon oath or affirmation is a
declaration that a statement is true and was made by a person upon oath or
affirmation. The person requesting this notarial act must personally appear before
the notary and sign the document in the presence of the notary. The notary
public is required to administer an oath. There is no prescribed wording for the
oath, but an acceptable oath would be:
 “Do You Swear (Or Affirm) That The Statements
 In This Document Are True?”
Verification upon oath may be taken in an individual capacity or in a representative
capacity. These short form certificates are sufficient to meet the requirements of
the law.

   verification upon oath or affirmation
         (in an individual capacity)
State of Illinois

County of ___________________.

Signed and sworn (or affirmed) to before me on ________________

______________________ (date) by ___________________________

(name of person making statement).

(seal)
    ________________________
    signature of notary public
 

  * * *
 

  verification upon oath or affirmation
  (in a representative capacity)
 

State of Illinois

County of ___________________.

Signed and sworn (or affirmed) to before me on __________________

______________________ (date) by _____________________________

(name of person) as ____________________________ (type of authority,

e.g., officer, trustee, etc.) of _____________________________________

(name of party on behalf of whom instrument was executed).

(seal)
    ________________________
    signature of notary public
 

Witnessing or Attesting a Signature
Occasionally, a notary public may be requested to witness a signature on a
document when no oath is necessary or required. The person requesting this
notarial act must personally appear before the notary and sign the document in
the presence of the notary. This short form certificate is sufficient to meet the
requirements of the law.

   witnessing or attesting a signature
State of Illinois

County of ___________________.

Signed (or subscribed or attested) before me on _______________

(date) by _______________________________________________

(name of person).

(seal)
    ________________________
    signature of notary public
 
 
 

Signature-by-Mark
When an individual requests a notarial act and the individual is prevented by
disability or illiteracy from writing a signature, take these precautions: positively
identify the individual; ensure that there are two persons to witness the signatureby-
mark in addition to yourself; write in the name of the signer-by-mark near the
mark on the document, and complete the form below.

    signature-by-mark

State of Illinois

County of ___________________.

This instrument was acknowledged before me on _________________

(date) by _________________________________________________

(name of person) who made and acknowledged making his/her mark
on the instrument in my presence and in the presence of two persons
who have signed below.

(seal)
    ___________________________
    signature of notary public
 

___________________________  ___________________________
signature and address  signature and address
of witness   of witness
 
 
 

Oaths or Affirmations
On rare occasions, a notary may be asked to administer a verbal oath or
affirmation. Illinois notaries public are authorized to administer such oaths not
only by the Notary Public Act but also by other state laws (Illinois Revised Statutes,
ch. 101). Notaries may administer oaths to witnesses, the oath of office to public
officials when an oath of office is required to be taken, and oaths on any other
occasion when an oath is required.

An oath contains the words, “I do solemnly swear . . . ,” and an affirmation contains
the words, “I do solemnly affirm . . . .” Either form may be used, as both are
effective in invoking the perjury statute against the maker of a false statement.

The exact wording of the oaths or affirmations can vary from situation to
situation. It is not the obligation of a notary to ascertain the proper wording of
an oath or affirmation, but the notary can administer it when the proper wording
is provided. Following is a constitutional oath or affirmation required to be taken
by most elected state and local officials.

Oath or Affirmation
“I do solemnly swear (affirm) that I will support the Constitution of the United
States, and the Constitution of the State of Illinois, and that I will faithfully discharge
the duties of the office of ________________________ to the best of my ability.”