Skip to main content Skip to office menu Skip to footer
Minnesota Legislature

Office of the Revisor of Statutes

358.66 SHORT FORM CERTIFICATES.

(a) The following short form certificates of notarial acts are sufficient for the purposes indicated, if completed with the information required by section 358.65, subdivisions 1 and 2:

(1) For an acknowledgment in an individual capacity;

State of .
County of .

This instrument was acknowledged before me on ..........(date) by ....................(name(s) of individual(s)).

.
(Signature of notarial officer)
(Stamp)
.
Title (and Rank)
My commission expires: .

(2) For an acknowledgment in a representative capacity:

State of .
County of .

This instrument was acknowledged before me on ..........(date) by ....................(name(s) of individual(s)) as ........................................(type of authority, e.g., officer, trustee, etc.) of ...............................................(name of party on behalf of whom the instrument was executed).

.
(Signature of notarial officer)
(Stamp)
.
Title (and Rank)
My commission expires: .

(3) For a verification upon 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 (and Rank)
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)).

.
(Signature of notarial officer)
(Stamp)
.
Title (and Rank)
My commission expires: .

(5) For attestation of a copy of a document:

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)
(Stamp)
.
Title (and Rank)
My commission expires: .

(b) For a remote notarization, use of alternate (1) or (2), as appropriate, is sufficient to satisfy the requirements of section 358.645, subdivision 7, paragraph (d):

(1) For a remote notarization when the signer is located outside the United States:

This record was (acknowledged)(signed and sworn to or affirmed)(signed or attested to) by use of communication technology on
. by .
Date who declared that (he)(she)(they) (is)(are) located
(Name(s) of Individual(s))
in (jurisdiction and location name) and that this record is to be filed with or relates to a matter before a court, governmental entity, public official, or other entity located in the territorial jurisdiction of the United States, or involves property located in the territorial jurisdiction of, or a transaction substantially connected with, the United States.

Or;

(2) For a remote notarization when the signer is located in Minnesota or the United States:

This record was (acknowledged)(signed and sworn to or affirmed)(signed or attested to) by use of communication technology on
. by .
Date who declared that (he)(she)(they) (is)(are) located
(Name(s) of Individual(s))
in (jurisdiction and location name).