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Oregon Notarial Certificate – Verification Upon Oath or Affirmation

The Oregon notarial certificate for verification upon oath or affirmation is used by registered notaries public to provide a jurat for the administration of an oath or affirmation. A jurat is a certificate that verifies that notary has witnessed the named individual making a sworn oath or affirmation and that said individual signed a statement in the notary’s presence. The certificate must be attached to the signed sworn statement, filled out by the notary, and stamped in order to validate the oath or affirmation. A sworn statement is made on penalty of perjury, and therefore, making a false oath or affirmation is a punishable crime.

Laws – § 194.280 and § 194.285(3)




State of Oregon                    }

County of ______________ }


Signed and sworn to (or affirmed) before me on _______________________ [Date], 20___ [Year] by _______________________________________ [Name(s) of Individuals Making Statement].


(Official Stamp)

Signature of Notarial Officer

Printed or typed name of Notarial Officer

Notary Public – State of Oregon

My commission expires: __________________


Document Description 

This certificate is attached to page ____ of a ________________________ [Title or Type of Document], dated _____________, 20 ___ , consisting of _______ pages.