Court Opinion

ID: 4058787
Source: CourtListenerOpinion
Date Created: 2016-09-29 09:19:27.611029+00
Date Added: 2024-06-11T14:33:41.462520
License: Public Domain

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ATC-06O (Rev. 7)
Attachment 2

NOTICE .
g OFFENDER NOTARY PUBLIC SERVICE

Under both Federal law (28 U.S.C § 1746) and State law (V.T.C.A. Civil Practice & Remedies
Code, §l32.00]-l32.003), offenders incarcerated in Texas may use an unsworn declaration under
penalty of perjury in place of a written declaration, verification, certification, oath, or affidavit

sworn before a Notary Public.

ln a request for Notary Public service, each offender must explain why an Uns`worn Declaration is
insufficient before Notary Public service will be provided `

**************************#************$**************************************

An example af an unsworn declaration pursuant lo State law is as follows:

"My name is C-’ia/\DY\ F}` _" ercihnq my date ofbirth is 9 1 l .S'&[Z ,

(First) (M iddle) (Last)

and my inmate identifying number, is \Y_\B\_'\ig'?¢'l_/ . l am presently incarcerated in

D<\\ Q.L€)\ \x¢\.\‘\’ ~< T‘O.C,§ in \bLuC& QGX;\C

 

 

` . (Corrections unit name) _ (City)
\>¢\C\\'\\’U\ ’\'€XCLS fl \03 l£'? . l declare under penalty of
(County) (State) (Zip Code)

  

perjury that the foregoing is true and correct.

 

Executed on the l'\-“r\day of S\M\€/ ' , 2

*****************$*****#**********************#******** ********#$#***********

An example of an unsworn declaration pursuan/ to Federal law is as follows:

(insert offender name and TDCJ number), being
(insert TDCJ unit name), in

County, Texas, declare under penalty of perjury that the foregoing is true

l
presently incarcerated in

 

 

and correct.

 

b Executed on the , day of ' , 20 .
` (Offender Signature)

*****************$****************************************************¥***#***

NOTICE
NOTARY PUBLIC SERVICE DENIAL

/ Regarding your request for Notary Public service, insufficient justification 'was provided
necessitating Notary Public service. l-lowever, you may proceed with an Unsworn Declaration.

l\>»~s~\z\we\i_`l»ma“brssgi\\ im ms

(Signature - Notary) (Date)

k .“)0\5 ()\g,¢\"\~ago\ no§r\’\(i?,O\i/vua off M\LS~Q O\o C\/\…AKJ @1/‘\\/\¢/\

L ‘ l l”f’