In addition to the acknowledgment of instruments in the manner and form and as otherwise authorized by this chapter, persons serving in or with the armed forces of the United States or their dependents, wherever located, may acknowledge the same before any commissioned officer in active service of the armed forces of the United States with the rank of second lieutenant or higher in the Army, Air Force or Marine Corps, or ensign or higher in the Navy or Coast Guard. The instrument shall not be rendered invalid by the failure to state therein the place of execution or acknowledgment. No authentication of the officer’s certificate of acknowledgment shall be required but the officer taking the acknowledgment shall endorse thereon or attach thereto a certificate substantially in the following form:

On this the …. day of …., 20.., before me, …., the undersigned officer, personally appeared …. (Serial No.) (if any) …., known to me (or satisfactorily proven) to be (serving in or with the armed forces of the United States) (a dependent of …., (Serial No.) (if any) …., a person serving in or with the armed forces of the United States) and to be the person whose name is subscribed to the within instrument and acknowledged that …. he …. executed the same for the purposes therein contained. And the undersigned does further certify that he is at the date of this certificate a commissioned officer of the rank stated below and is in the active service of the armed forces of the United States.

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Signature of the Officer

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Rank and Serial No. of Officer

and Command to which attached.