486.395. Upon the receipt of a written request, the notarized documentand a fee of ten dollars payable to the director of revenue, the secretary ofstate shall provide a certificate of authority in type not smaller than eightpoint and in substantially the following form:
I, ...... (appointing state official, or local or district officedesignated by appointing state official, name and title) of the State of (nameof state) which office is an office of record having a seal, certify that...... (notary's name), by whom the foregoing or annexed document wasnotarized, was, at the time of the notarization of the same, a Notary Publicauthorized by the laws of this State to act in this State and to notarize thewithin ...... (type of document), and I further certify that the Notary'ssignature on the document is genuine to the best of my knowledge, information,and belief and that such notarization was executed in accordance with the lawsof this State.
In testimony whereof, I have affixed my signature and seal of this officethis ...... day of ......, 20.... ............................................................... (secretaryof state's signature, title, jurisdiction, address and the seal affixed nearthe signature)
(L. 1977 H.B. 513 ยง 41, A.L. 1988 H.B. 1068, A.L. 2004 H.B. 1193)