Authentication Order Form - In-Person printable pdf download

TATE OF

HODE

SLAND AND

ROVIDENCE

LANTATIONS

Office of the Secretary of State

148 W. River St., Providence RI 02904-2615

(401) 222-1487

Authentication Order Form - In-Person

This form is to be completed to pre-order authentication certificates for in-person certification of more than 5 public documents.

INSTRUCTIONS

• Prior to visiting our Authentication Section, complete the “Order Information” below and fax the completed form

to our office at 401-222-1309. If your order contains more documents than provided for below, please download

and complete the Authentication Order Attachment Form. Our staff will contact you to confirm the appointment

time that you have requested below.

• DO NOT FAX the document(s) to be authenticated. Please bring your original documents to our office at the

pre-determined appointment time. Documents to be authenticated must contain the original signature of a Rhode

Island public official whose appointment of office is on record with the office of the Secretary of State.

• Payment must be rendered at the time the order is filled. Make checks payable to “RI Secretary of State.”

FEES

$5.00 per certificate

ORDER INFORMATION

(PLEASE TYPE OR PRINT LEGIBLY)

1. Your Name ____________________________________________ 2. Date of Request ________________

3. Daytime Telephone Number ______________________________ 4. Email ________________________

5. Street Address ____________________________________________________________________________

6. Requested Appointment Date

__________________ Requested Time of Appointment ________________

(Office Hours: Monday - Friday 8:30 AM - 4:30 PM except for scheduled holidays)

DOCUMENT 1

Country in which your document(s) will be used __________________________________________________

Type of certificate(s) requested

Certification

Apostille

(CHECK ONE)

Number of certification/apostille certificates requested ______________________________________________

Name and title of official signing the document

______________________________

(i.e. Notary Name or other official)

________________________________________________________________________________________

DOCUMENT 2