Georgia Jurat

Statutory basis: This jurat is executed pursuant to O.C.G.A. § 45-17-8, which authorizes notaries public to administer oaths and affirmations. A jurat certifies that the signer personally appeared, signed the document in the notary's presence, and swore or affirmed under penalty of perjury that the contents are true. The signer must not sign before appearing before the notary.

County of Execution

State

County

Sworn Statement

Before me, the undersigned notary public, on this day of , , personally appeared , who, being by me duly sworn (or affirmed), deposes and says that the contents of the foregoing instrument are true and correct to the best of the signer's knowledge and belief.

The signer signed this instrument in my presence.

Administered as:

Oath (swear) Affirmation (affirm, for those with religious or conscientious objection to swearing)

Signer's Signature

Signer — must sign in notary's presence

Signature of Signer

Printed Name

Printed Name of Signer

Notarial Certificate

Subscribed and sworn to (or affirmed) before me by in County, Georgia, on the date set forth above.

Signature of Notary Public

Commission Expiration Date

Printed Name of Notary Public

Official Capacity of Officer

Affix official notary stamp here. O.C.G.A. § 45-17-8 authorizes Georgia notaries to administer oaths and affirmations. The notary is not an attorney and cannot provide legal advice.

Notarial Jurat