State (territory or district) of _______________, county of ___________, to wit:
I, ___________________, a commissioner, appointed by the Governor of the State of West Virginia, for the said State (or territory or district) of ___________ ; or I,
_________________, a justice of the peace of the county aforesaid; or I, _________________, a notary public of said county; or I, ____________, a notary (or clerk) of the court of said county; (or other office or person authorized to take acknowledgments by section three of this article, as the case may be), do hereby certify that ______________________, whose name (or names) is (or are) signed to the writing above (or hereto annexed) bearing date on the _______ day of ________, 20_____, has (or have) this day acknowledged same before me, in my said __________________.
Given under my hand this ________ day of _______________, 20________.
My commission expires the ________ day of _________, 20_______.
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