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  • 1779 Declaration American Federal Man Notary

    Uploaded by

    Ralf Wittke
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    This document contains a sample page for a notarized declaration. It includes fields for the declarant's name, birth state, county, and signature. The bottom section provides a template for a notary witness and acknowledgement, with spaces to fill in the declarant's name, date, year, notary's signature and seal, and the expiration date of the notary's commission.

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    1779-Declaration-American-federal-Man-Notary

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    This document contains a sample page for a notarized declaration. It includes fields for the declarant's name, birth state, county, and signature. The bottom section provides a template for a notary witness and acknowledgement, with spaces to fill in the declarant's name, date, year, notary's signature and seal, and the expiration date of the notary's commission.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    6 views2 pages

    1779 Declaration American Federal Man Notary

    Uploaded by

    Ralf Wittke
    This document contains a sample page for a notarized declaration. It includes fields for the declarant's name, birth state, county, and signature. The bottom section provides a template for a notary witness and acknowledgement, with spaces to fill in the declarant's name, date, year, notary's signature and seal, and the expiration date of the notary's commission.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 2

    SAMPLE PAGE

    Born State

    County Name Your State

    Your State

    By: _________________________________________ ©

    [ By: John Henry Doe © ]

    Notary Witness and Acknowledgement


    _________________State
    _________________County

    Today before me, a Commissioned Notary, is the living man known to me to be _____________________________and he
    did issue this Declaration of the Naturalization Act of July of 1779 as shown and he also affirmed his testimony as shown
    before me this ____day of _______________in the year ___________, in Witness whereof I set my Signature and
    Seal:_____________________________________ Public Notary; my commission expires on:_____________________.

    SAMPLE PAGE
    Form ASN 1-F-Man/SS Revision: 11/19/2021

    By: _________________________________________ ©

    [ ]

    Notary Witness and Acknowledgement


    _________________State

    _________________County

    Today before me, a Commissioned Notary, is the living man known to me to be _____________________________and he
    did issue this Declaration of the Naturalization Act of July of 1779 as shown and he also affirmed his testimony as shown
    before me this ____day of _______________in the year ___________, in Witness whereof I set my Signature and
    Seal:_____________________________________ Public Notary; my commission expires on:_____________________.

    Form ASN 1-F-Man/SS Revision: 11/19/2021

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