21 Pa. Stat. § 291.7
An officer taking the acknowledgment shall endorse thereon or attach thereto a certificate substantially in one of the following forms:
State of ________________________
County of ______________________
On this, the ____ day of ____________, 19____, before me __________, the undersigned officer, personally appeared __________, known to me (or satisfactorily proven) to be the person whose name ____________ subscribed to the within instrument, and acknowledged that ____________ he ____________ executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
________________________
________________________
Title of Officer
State of ________________________
County of ______________________
On this, the ______________ day of ____________, 19____, before me __________, the undersigned officer, personally appeared __________, who acknowledged himself to be the ____________ of ____________, a corporation, and that he as such ____________, being authorized to do so, executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by himself as ____________.
In witness whereof, I hereunto set my hand and official seal.
________________________
________________________
Title of Officer
Any deed, conveyance, mortgage or other instrument in writing, made and executed by a corporation, may be acknowledged by any officer of said corporation whose signature appears on such deed, conveyance, mortgage or other instrument in writing, in execution or in attestation of the execution thereof.
State of ________________________
County of ______________________
On this, the ____ day of ____________, 19____, before me __________, the undersigned officer, personally appeared __________, known to me (or satisfactorily proven) to be the person whose name is subscribed as attorney in fact for ____________, and acknowledged that he executed the same as the act of his principal for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
________________________
________________________
Title of Officer
State of ________________________
County of ______________________
On this, the ____ day of ____________, 19____, before me __________, the undersigned officer, personally appeared ____________ of the State (County or City as the case may be) of ____________ known to me (or satisfactorily proven) to be the person described in the foregoing instrument, and acknowledged that he executed the same in the capacity therein stated and for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
________________________
________________________
Title of Officer
State of ________________________
County of ______________________
On this, the ______ day of __________, 19___, before me ________________________, the undersigned officer, personally appeared ________________________, known to me (or satisfactorily proven) to be a member of the bar of the highest court of said state and a subscribing witness to the within instrument, and certified that he was personally present when __________ whose name ________________________ subscribed to the within instrument executed the same, and that said person _________________________________________________________________________ ____________________ acknowledged that ______ he ______ executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
________________________
________________________
Title of Officer
21 P.S. § 291.7