Indiana Notary Acknowledgement Template
This document serves as an official acknowledgment for use in the state of Indiana, in accordance with Indiana Code § 33-42-4-1. Please fill in the blanks with the appropriate information.
State of Indiana
County of ____________________
Before me, the undersigned notary public, personally appeared:
Name of Signer: _______________________________
Address of Signer: _____________________________
City, State, Zip Code: ________________________
who is personally known to me or who has provided satisfactory evidence of identity, and who acknowledged executing the following instrument:
Document Title: ________________________________
Date of Document: _____________________________
In witness whereof, I have hereunto set my hand and affixed my official seal this ____ day of ____________, 20__.
Signature of Notary Public: _______________________________
Printed Name of Notary Public: _________________________
My Commission Expires: ________________________________
Notary Seal: