"State of __________
County of __________
I certify that the foregoing and attached document entitled __________ (insert document title), dated __________ (insert document date) and containing _____ pages, is a true and correct copy of an electronic record printed by me or under my supervision. I further certify that, at the time of printing, no security features present on the electronic record indicated any changes or errors in an electronic signature or other information in the electronic record after the electronic record's creation or execution.
Signed this _____ day of _____, _____
__________ (signature of notarial officer)
__________ (printed name of notarial officer)
__________ (include notarial officer's commission number, official seal, commission county of residence or employment, and commission expiration date as required by applicable law).".
IC 32-21-2.5-12