Copy Certification by Document Custodian
[Pages:1]Copy Certification by Document Custodian
STATE OF ____________________ COUNTY OF ____________________
Before me, the undersigned authority, personally appeared ____________________________, (Affiant), who first being duly sworn by me, under penalty of perjury, deposed as follows:
1. My name is __________________________________________. I am over the age of 18 and fully competent to make this affidavit. The facts stated herein are true and correct and are based on my personal knowledge.
2. I am the custodian of the records for ___________________________, kept at address _____________________________________________________________________.
3. My capacity as records custodian is as: _____________________________________. [individual, business owner/officer/manager, secretary, school/university officer, attorney, accountant, bookkeeper, trustee, agent, government officer/agent, other]
4. Attached hereto are ______ pages of records, described as follows: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________. [document title, type, description, date, ID #, signer, issuing agency, form number]
5. The said records attached hereto are exact duplicates of the originals, and are true, correct and complete.
6. Other: ________________________________________________________________ _____________________________________________________________________.
_____________________________ Affiant's Signature
SUBSCRIBED AND SWORN TO OR AFFIRMED before me on this _____ day of _____________________, _________ by Affiant ___________________________________.
______________________________ [Seal] Notary Public
_____________________ My commission expires
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- certification of records attestation of exemplified copies
- bcia 8374 custodian of records application for
- certification by custodian of records j
- copy certification by document custodian
- certification of medical records
- district court of maryland for
- declaration of custodian of records
- gov
- medical records certification kentucky
- 700 110 certification of documents treasury
Related searches
- how to send a document by email
- document get element by tag
- document get element by class
- document get elements by class
- copy of acls certification card
- get document by class
- copy of cpr certification card
- resume for custodian or janitor
- how to search for document by date
- walmart pharmacy custodian of records
- how to copy a document in word
- document how to get element by id