Texas Sample Notary Forms Page 6

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PROTESTS
(Insert bill or note or copy thereof)
United States of America
State of Texas
County of _______________
Be it known that on the __________ day of __________, (year), at the request of
(name), of __________, I, (notary public's name), a notary public duly
commissioned and sworn, residing in __________ County, Texas, did present
the original (instrument), hereto attached, for $__________, with accrued interest
thereon of $__________, dated __________, and demanded payment (or
acceptance) thereof, which was refused.
Whereupon I, at the request of the aforesaid __________, did protest, and by
these presents do protest, as well against the drawer, maker, endorsers, and
acceptors of said instruments as against all others whom it may concern, for
exchange, costs, charges, damages, and interest already incurred and
hereinafter to be incurred by reason of non-payment thereof. I further certify that
on (date), notice in writing of the foregoing presentment, demand, refusal and
protest was given by (persons and status) by depositing notices thereof in the
post office at __________, Texas, postage paid, directed as follows:
____________________. I further certify that notices were left as follows:
Notice left for _______________ at _______________
Notice left for _______________ at _______________
Each of the named places the reputed place of residence of the person for whom
the notice was left.
In testimony whereof I have hereunto set my hand and affixed my seal of office at
__________, Texas, on __________ day of ________________, (year).
________________________
(Personalized Seal)
Notary Public's Signature

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