Cite as: 49 CNCA § 119

The following short form certificates of notarial acts are sufficient for the purposes indicated, if completed with the information required by 49 CNCA § 118(A);

1.For an acknowledgment in an individual capacity:

Cherokee Nation

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 commission expires)

2.For an acknowledgment in a representative capacity:

Cherokee Nation

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).

_______________________________________

(Signature of notarial officer)

(Seal, if any)

_______________________________________

Title (and Rank)

(My commission expires)

3.For verification upon oath or affirmation:

Cherokee Nation

State of

County of

Signed and sworn (or affirmed) before me on (date) by (name(s) of person(s) making statement).

_______________________________________

(Signature of notarial officer)

(Seal, if any)

_______________________________________

Title (and Rank)

(My commission expires)

4.For verification upon oath or affirmation:

Cherokee Nation

State of

County of

Signed or attested before me on (date) by (name(s) of person(s)).

_______________________________________

(Signature of notarial officer)

(Seal, if any)

_______________________________________

Title (and Rank)

(My commission expires)

5.For attestation of a copy of a document:

Cherokee Nation

State of

County of

I certify that this is a true and correct copy of a document in the possession of

Dated

_______________________________________

(Signature of notarial officer)

(Seal, if any)

_______________________________________

Title (and Rank)

(My commission expires)