Application For Appointment As Notary Public Page 6

Question 3.

Question 4.

JURAT

I affirm, under penalty of false statement, that my statements and answers to all questions in this application and

examination are true and complete; that I have read the Connecticut notary laws and manual provided with this

application; and, I will faithfully perform my duties as a Notary Public to the best of my ability and in

accordance with Connecticut’s notary public laws.

Signature of Applicant________________________________________________________

Subscribed and sworn to before me, this__________________________day of_________________________20__________

__________________________________________________

Notary Public; Justice of the Peace; Town Clerk;

My Commission Expires________________

Commissioner of the Superior Court; (and or other official

(if Notary Public)

empowered to administer oaths by section 1-24 of the Conn.

General Statutes).

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