Free notary acknowledgement 09
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Affidavit
State of , County
of
My current legal name is , and my current occupation is . I am presentlyyears old, and my
current
address of residence is , , .
.
I hereby state that the information above is true, to the best of my knowledge. I also
confirm that
the information here is both accurate and complete, and relevant information has not been
omitted.
Signature of
Individual
Date

Notary Public

Title And
Rank
Date Of Commission Expiry