DO NOT WRITE IN THIS SPACE State of Arizona Request for Apostille/Certificate of Authentication Mail to: Arizona Secretary of State Ken Bennett Attention: Business Services, Notary Division 1700 W. Washington Street, 7th Fl., Phoenix, AZ 85007-2888 (602) 542-6187 (800) 458-5842 (within Arizona) Website: www.azsos.gov The Secretary of State issues apostilles (certificates of notarization authenticity) on documents being sent to a foreign country and also authenticates public documents being sent to foreign countries. An apostille from the Arizona Secretary of State's Office certifies an ARIZONA NOTARY, STATE CLERK, JUDGE or other PUBLIC OFFICER whose oath is on file with the Secretary of State. FOR OFFICE USE ONLY – REV. 06/15/10 REQUEST FOR APOSTILLE/CERTIFICATE OF AUTHENTICATION (A.R.S. § 41-326) About this form Use this form to request an apostille or certificate of authentication under A.R.S. § 41-326. Do NOT use this form if the document for which you are seeking an apostille has been signed or notarized by a federal official. Direct your request to the United States Department of State at (202) 647-5002. Such documents might include those that have been signed by a federal official with the official seal of that agency, American Consular Officer, Military Notary (10 USC 1044a) or Foreign Consul. Types of documents authenticated Government documents such as a birth certificate, death certificate, marriage record, corporation document, etc. must be a CERTIFIED COPY issued by that government office. Processing Fee: $3.00 PER DOCUMENT Payment: Checks or money orders shall be made payable to the Secretary of State. Credit cards are not accepted. Cash accepted in-person only. How to complete this form To avoid registration errors please write legibly or computer generate this request. This form has been designed to be filled out and printed online at the website referenced above. Read this form carefully, and fill in all blank spaces. Sign and date the form. File by mail with payment, AND include a self-addressed, postage paid envelope to avoid any delays or rejections. We are unable to process any requests with insufficient postage. If you send your documents by mail and require expedited service you may want to use express mail and include a self-addressed, prepaid express mail envelope for the return of the processed documents. You may also return this completed form in person at the following locations: PHOENIX - State Capitol TUCSON - Arizona State Executive Tower Complex Building 1700 W. Washington Street 400 W. Congress First Floor, Room 103 Second Floor, Room 252 Open Monday - Friday, 8 a.m. - 5 p.m., except state holidays. 1. Type of document(s) Type of Document Type of Document Type of Document Type of Document 2. This/these documents are being certified for the country of: Name of Country 3. Requestor Information: Requestor’s First Name Requestor’s Last Name Address (include street, box or suite number) Phone Number (include area code) City State Requestor’s Signature Zip Code Date 4. Submission: Enclosed is a CHECK MONEY ORDER for the amount of $ to cover the cost of processing documents. Also enclosed is a self-addressed stamped envelope for the return of the documents. Office Form SOSBSAP State of A ri zona - Apostille/Certif icate of A uthenti cati on R eques t Form American LegalNet, Inc. www.FormsWorkFlow.com