Authentication And Apostille Certificate Order Form Page 2
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WISCONSIN SECRETARY OF STATE
Apos # _____________
Apos. or Auth. X _______
Authentication and Apostille Certificate Order Form
Date_______/____/_____
A separate Authentication & Apostille Certificate Request Form is needed for each
Initials _______________
different country, Submit a document for each certificate you request; Each
Expedited Fee ________
Authentication or Apostille certificate will be attached to your document.
Credit # _____________
Credit $ _____________
1. CONTACT INFORMATION: Name, address and phone # of person filling out this form.
Name:
_________________________________________
Address:
_________________________________________
_________________________________________
Phone # or email:
_________________________________________
2. COUNTRY: List the country that requires the Apostille or Authentication. (NOT USA)
____________________________________________________________________________
3. VENEZUELA OR ARGENTINA ONLY
_____ Apostille or _____ Authentication
4. FEES: Total Number of ORIGINAL certified documents enclosed ___________
Please complete either Standard Service OR Expedited Service NOT BOTH.
*Standard Service (completed in 1-10 Business Days)
Total Documents______ X $10.00 = $_______
OR
**Expedited Service (completed in 1-5 Business Days)
Total Documents______ X $35.00 = $______
TOTAL MONEY ENCLOSED $_____________________
* Standard Service – Wisconsin Statutes requires a $10.00 fee for each certificate completed within 1 - 10
business days after receipt. This does not include shipping time.
** Expedited service - Wisconsin Statutes requires a $35.00 fee for each certificate completed within 1 - 5
business days after receipt. This does not include shipping time.
5. RETURN: How do you want to receive your documents? Please mark one option.
_____ I am sending a stamped self-addressed envelope.
_____ I am sending an electronic preprinted way bill for UPS, FedEx or Express Mail.
_____ I am submitting the FedEx Return Shipment Form.
_____ I will pick up my documents. My daytime phone #: _______________________
Make checks payable to Secretary of State. Please send one check for multiple requests.
Credit Cards NOT Accepted!! Send order forms, documents, fee payment and return envelope
to:
Wisconsin Secretary of State,
Certification Desk
th
30 W Mifflin St, 10
Floor
Madison, WI 53703
For office use only
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