Missouri Notarial Certificates Page 3

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____________________________
Official signature and official seal of
person acting as a notary and refer to
law or authority granting power to
act as a notary
By An Individual Who Cannot Write His or Her Name
State of ______________
County and or City of _________
On this _____day of ______ in the year_____before me, (name of notary), a Notary
Public in and for said state, personally appeared (name of individual), known to me to be
the person who, being unable to write his or her name, made his or her mark in my
presence.
I signed his or her name at his or her request and in that person’s presence on the within
(type of document) and he or she acknowledged to me that he or she made his or her
mark on the same for the purposes therein stated.
_________________
Seal
Notary Public
By a Manager or Member
State of ______________
County and or City of _________
On this _____day of ______ in the year_____before me, (name of notary), a Notary
Public in and for said state, personally appeared (name of manager or member) of (name
of limited liability company), known to me to be the person who executed the within
(type of document) in behalf of said limited liability company and acknowledged to me
that he or she executed the same for the purposes therein stated.
_________________
Seal
Notary Public
Affirmations
Subscribed and affirmed before me this ______ day of ________, 20____.
_________________
Seal
Notary Public
If affirmation is not in writing

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