Form Fl-2003-Jur - Notary Form
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1State of FLORIDA
County of ______________
Sworn to (or affirmed) and subscribed before me this ______ day of
_______________, 20______ by ________________________________,
who q is personally known to me or q produced a ___________________
as identification, regarding the attached instrument described as:_________
___________________________________________________________
and to whose signature this notarization applies.
(Seal)
_______________________________
notary public signature
__________________________________
notary public printed name
provides this form pursuant to Florida Statutes §117.05(13)(a)
FL-2003-JUR
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