A notary public is an officer authorized by the state in which the person resides to administer oaths, take acknowledgments, certify documents and to take depositions if the notary is also a court reporter. The signature and seal or stamp of a notary public is necessary to attest to the oath of truth of a person making an affidavit. The appointment, qualification, duties, powers, and liabilities of notaries are defined and regulated in detail by statute in the various jurisdictions.
This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.