JURAT

SUBSCRIBED and sworn to before me, this ___ day of __________, in the City of
______________ by _________ with Passport number ___________, issued on _________ at
_________.

Doc. No. _____

Page No. _____
Book No. _____
Series of _____

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NOTES:
>>> An act in which an individual on a single occasion:
1. Appears in person before a NP and presents an instrument or doc;
2. Is personally known to the NP through competent evidence;
3. Signs the instrument or doc IN THE PRESENCE OF THE NOTARY;
4. Takes an oath or affirmation before the NP as to such instrument or document.

>>> Commonly used in AFFIDAVITS ; CERTIFICATIONS