Kansas Notary Public Packets Page 28
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51Kansas Notary Handbook
be corrected. if the officer is a commissioned officer on active duty in the
military service of the united states, it must also include the officer’s rank.
(b) a certificate of a notarial act is sufficient if it meets the requirements of sub
section (a) and it:
(1) is in the short form set forth in K.s.a. 53-509;
(2) is in a form otherwise prescribed by the law of this state;
(3) is in a form prescribed by the laws or regulations applicable in the place
in which the notarial act was performed; or
(4) sets forth the actions of the notarial officer and those are sufficient to
meet the requirements of the designated notarial act.
(c) by executing a certificate of a notarial act, the notarial officer certifies that the
officer has made the determinations required by K.s.a. 53-503.
53-509. Short forms. The following short form certificates of notarial acts are suf
ficient for the purposes indicated, if completed with the information required by
subsection (a) of K.s.a. 53-508:
(a) For an acknowledgment in an individual capacity:
state of ___________________________
(county) of ________________________
This instrument was acknowledged before me on ___(date)__ by
____ [name(s) of person(s)]____.
_________________________________
(signature of notarial officer)
(seal, if any)
_________________________________
title (and rank)
[My appointment expires: _______]
(b) For an acknowledgment in a representative capacity:
state of ___________________________
(county) of ________________________
This instrument was acknowledged before me on ___[date]___ by
___[name(s) of person(s)]___ as ___(type of authority, e.g., officer, trustee,
etc.)___ of ___(name of party on behalf of whom instrument was executed)___.
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