West Virginia Code
Article 4. Revised Uniform Law on Notarial Acts
§39-4-16. Short Form Certificates

The following short form certificates of notarial acts are sufficient for the purposes indicated, if completed with the information required by subsections (a) and (b), section fifteen of this article:
(1) For an acknowledgment in an individual capacity:
State of .....................................
County of ...................................
This record was acknowledged before me on .............. [Date] by ........................................ [Name(s) of individual(s)]............................................................
Signature of notarial officer
Stamp
Title of office ...........................................
My commission expires: ..........................
(2) For an acknowledgment in a representative capacity:
State of ....................
County of ....................
This record was acknowledged before me on .............. [Date] by ....................................................... [Name(s) of individual(s)] as ............................ [Type of authority, such as officer or trustee] of .......................... [Name of party on behalf of whom record was executed].
..............................
Signature of notarial officer
Stamp
Title of office........................................
My commission expires: ..........................
(3) For a verification on oath or affirmation:
State of ....................
County of ....................
Signed and sworn to (or affirmed) before me on ............ (Date) by .................................................... [Name(s) of individual(s) making statement]
..............................
Signature of notarial officer
Stamp
Title of office .............................................
My commission expires: ..........................
(4) For witnessing or attesting a signature:
State of ....................
County of ....................
Signed or attested before me on ...................... [Date] by ...................................... [Name(s) of individual(s) making statement]
..............................
Signature of notarial officer
Stamp
Title of office ............................................
My commission expires: ..........................
(5) For certifying a copy of a record:
State of ....................
County of ....................
I certify that this is a true and correct copy of a record in the possession of ......................................
Dated ...........................
..............................
Signature of notarial officer
Stam
Title of office ...........................................
My commission expires: ..........................