I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or she signed the foregoing document:. I,. , a Notary Public for said County and.Fill out, sign, and affix your official seal to the Notary certificate. The wording requirements for acknowledgment certificates vary from state to state. Looking for local rules and forms? Create your acknowledgment letter template. Use an LGL letter template; Use a Microsoft Word letter template. In the sample complaint form, note the choices of boxes the plaintiff may use. You can check a box and fill in the information on the line next to the box. Acknowledgment for Short Form Power of Attorney.