Nonresident Notary Public Affidavit Of Applicant Form - State Of Nevada (Page 3 of 3) in pdf

Nonresident Notary Public Affidavit Of Applicant Form - State Of Nevada Page 3

Nonresident Notary Public

Affidavit of Self-Employed Applicant

STATE OF NEVADA

STATE OF ___________________

COUNTY OF _________________

I, ___________________________________________________, being first duly sworn,

(Self-employed Applicant)

state upon personal knowledge and under penalty of perjury as follows:

1. My residence address is___________________________________________

_________________________________________________________________

2. I am self-employed

3. My business,_____________________________________________

is licensed to do business in the State of Nevada.

4. The address of my place of business is__________________________________

__________________________________________________________________

5. My business telephone number is______________________________________

DATED this ________day of______________,_______.

____________________________________

Self-employed Applicant

Signed and sworn to before me

On______________________

By______________________

_________________________

Notary Public

Nonresident Notary Public Affidavit Of Applicant Form - State Of Nevada Page 3