The clerk should also enter on the petition a certificate substantially in the following form:

I certify that on the ______ day of ______________, ____, I mailed to each of the following persons a copy of the within petition and process to his post office address as disclosed by the record: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

and that advertisement has been published in accordance with law, a copy of said advertisement being hereto attached.

This ______ day of ______________, ____.

_______________ Clerk