Legal Witness Notary Form
Document Title:
Date:
Location:
Declarant Information
Full Name:
Address:
Phone Number:
Email:
Witness Information
Full Name:
Address:
Phone Number:
Notary Public Information
Full Name:
License/Commission Number:
Expiration Date:
State/Country:
Acknowledgment by Affiant/Declarant
I, the undersigned, acknowledge that the information provided is true and accurate to the best of my knowledge.
Signature of Affiant:
Date:
Witness Acknowledgment
We, the undersigned, verify that the affiant signed the document in our presence and of their own free will.
Signature Witness 1:
Date:
Signature Witness 2:
Date:
State of
County of
On this day of , 20, before me, the undersigned Notary Public, personally appeared (Affiant), who proved to me through satisfactory evidence of identification, to be the person whose name is signed above.
I certify under penalty of perjury that the foregoing is true and correct.
Signature of Notary Public:
Date:
Seal
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