Affirmation for Appointment and Commission as a Notary Public INSTRUCTIONS FOR COMPLETION Make sure you are using the most recent form. If this is not the most recent form, the Department of State will be unable to process any portion of your application. Applicant : The person registering or renewing a notary commission. 1. Type your name as it appears on your go vernment issued identification. (Ex : d Note : Yo ur middle name or suffix is optional, but if it is included here, it must be included on the online application for registration/renewal . Print Affirmation and go to a current notary with a commission issued by the state of Colorado. 2. In front of a notary, sign the affirmation using your official signature. This is the signature that is kept on file and will be used to authenticate the documents you have notarized. Notary : Individual with a current notary commission issued by the state of Colorado. Failure to correctly notarize this document may by grounds for admonishment. Write the county where the notarization istaking placeWrite the name of the applicant thatsigned the documentSign the affirmation using your officialsignatureWrite your Title. This will always be one ofthe following:Notary PublicClerkDeputy ClerkJudgeWrite the date of your commission expirationStamp the document ensuring the stamp is COMPLETELY in the white space at thebottomComplete a journal entry for this notarization. American LegalNet, Inc. www.FormsWorkFlow.com Affirmation Page 1 of 1 Rev. //2019 Affirmation for A ppointment and C ommission as a N otary P ublic I, , solemnly affirm, under the penalty of perjury in the second degree, as defined in section 18 - 8 - 503, Colorado Revised Statutes, that I have carefully read the notary law of this state, and if appointed and commissioned as a notary public, I will faithfully perform, to the best of my ability, all notarial acts in conformance with the law. I understand that this sworn statement is required by law because I have applied for a public benefit. I understand that state law requir es me to provide proof that I am lawfully present in the United States prior to receipt of this public benefit. I further acknowledge that knowingly making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is punishable under the criminal laws of Colorado as perjury in the second degree under section 18 - 8 - 503, Colorado Revised Statute s , and it shall constitute a separate criminal offense each time a public benefit is received based on such statement or representation . official signature (must sign in front of a notary) S tate of Colorado County of Signed and sworn to [or affirmed] before me on , 20 by (). Notary Title (Notary Public, Clerk, Deputy Clerk or Judge) Commission expiration ( Stamp ) Type name as it appears on your ID (middle name optional) Applicant Notary American LegalNet, Inc. www.FormsWorkFlow.com