State of Missouri |
County (and/or City) of __________ |
On this ______ day of _____, 20 _____, before me, the undersigned notary, personally appeared by remote online means ________ (name of document signer), (personally known to me) (proved to me through identification documents, which were __________,) (proved to me on the oath or affirmation of ___________, who is personally known to me and stated to me that (he)(she) personally knows the document signer and is unaffected by the document,) (proved to me on the oath or affirmation of _____ and ______, whose identities have been proven to me through identification documents and who have stated to me that they personally know the document signer and are unaffected by the document,) to be the person who signed the preceding or attached document in my presence and who swore or affirmed to me that the contents of the document are truthful and accurate to the best of (his)(her) knowledge and belief. |
________________________(official signature and seal of notary) |
State of Missouri |
County (and/or City) of ____________ |
On this ______ day of _______, 20 ______, before me, the undersigned notary, personally appeared by remote online means ________ (name of document signer), (personally known to me) (proved to me through identification documents, which were _______,) (proved to me on the oath or affirmation of _____________, who is personally known to me and stated to me that (he)(she) personally knows the document signer and is unaffected by the document,) (proved to me on the oath or affirmation of _____ and ______, whose identities have been proven to me through identification documents and who have stated to me that they personally know the document signer and are unaffected by the document,) to be the person whose name is signed on the preceding or attached document, and acknowledged to me that (he)(she) signed it voluntarily for its stated purpose(.) |
(as partner for _____________, a partnership.) |
(as _______ for ___________, a corporation.) |
(as attorney in fact for ______, the principal.) |
(as _____ for ______, (a)(the) __________) |
___________________ (official signature and seal of notary) |
§ 486.1175, RSMo