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Notary Form for a Passport
This form allows you to make a statement affirming your passport and have it verified by a notary. The first section provides fields for identifying the person, followed by the declaration and then verification by the notary.

Free Sample Template
Format: Word PDF
# of Pages: 1
Printable: Yes

Notary Form for a Passport TemplateForm 1999
Format: Word PDF
Category: Legal, Notary
Type: Form

Notary Form for a Passport

Name: ________________________________________________________________________________________

Address: ______________________________________________________________________________________

City: ______________________________________ State: __________ Zip Code: ___________________________

I, the above listed passport bearer personally appeared before the undersigned notary public and under oath or affirmations do hereby make the following statements:

I am the legal bearer of the presented United States Passport Number #: _________________________________,

Issued on: ___/___/_____ and having an expiration date of: ___/___/_____.

My date of birth is: ___/___/_____

I, hereby declare that the reproduction of this passport is a true, correct and complete photocopy of the passport that is in my possession and control.

Passport Bearerís Signature: ____________________________________________________ Date: ___/___/_____

State of: __________________________

County of: ________________________

The foregoing document was acknowledged before me this _________________ day of ______________________

20_____, at _____________________________________ in the State of: _________________________________

By: __________________________________________________________________________________________

To be his or her free act of deed.

Signature of Notary Public: _______________________________________________________________________

My commission expires: ___/___/_____

SEAL